Individual provider Active NPI

Simone Stephens Reeves, MA,LPC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1528237369
Registry record updated Dec 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
11709 Fruehauf Dr Ste 225
Charlotte, NC 28273-0043
Phone
(704) 840-2848
NPI assigned
Feb 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7160 NC
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

11709 Fruehauf Dr Ste 225
Charlotte, NC 28273-0043

Mailing address

1659 Sandpiper Dr
Rock Hill, SC 29732-3088
Phone (704) 840-2848

Other practice location 1

7834 E Berkeley Rd
Denver, NC 28037-8489
Phone (704) 840-2848

Other identifiers 1

IdentifierTypeStateIssuer
6104316MedicaidNC

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7160NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Choosing Change Residential Services LLC CurrentSince Dec 16, 2020 Accepting new patients

Locations

11709 Fruehauf Dr
Ste 225
Charlotte, NC 28273
Phone (404) 849-8774

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1528237369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 SANDPIPER DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323088",
            "telephone_number": "704-840-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11709 FRUEHAUF DR STE 225",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282730043",
            "telephone_number": "704-840-2848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7834 E Berkeley Rd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280378489",
            "country_code": "US",
            "telephone_number": "704-840-2848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEVES",
        "first_name": "SIMONE",
        "middle_name": "STEPHENS",
        "credential": "MA,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7160",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104316",
            "state": "NC"
        }
    ],
    "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 Dec 12, 2020; 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.