Individual provider Active NPI

Samekquel Latonya McGill, LCMHCA

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1508457805
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178016567 Issued in IL
Practice address
769 N Wendover Rd
Charlotte, NC 28211-1118
Phone
(704) 376-7180
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178016567 IL Primary

Addresses

Primary practice location

769 N Wendover Rd
Charlotte, NC 28211-1118

Mailing address

769 N Wendover Rd
Charlotte, NC 28211-1118
Phone (704) 376-7180

Other practice location 1

616 W Fulton St
Chicago, IL 60661-1251
Phone (312) 625-3722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178016567ILMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1508457805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 N WENDOVER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111118",
            "telephone_number": "704-376-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 N WENDOVER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111118",
            "telephone_number": "704-376-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 W Fulton St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606611251",
            "country_code": "US",
            "telephone_number": "312-625-3722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGILL",
        "first_name": "SAMEKQUEL",
        "middle_name": "LATONYA",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178016567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.