Individual provider Active NPI

Chontelai Patterson Mendie, LCPC

  • Professional Counselor
  • Bowie, MD
National Provider Identifier
1538630967
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC10348 Issued in MD
Practice address
15602 Everglade LN Apt 303
Bowie, MD 20716-3245
Phone
(646) 244-7633
NPI assigned
Dec 11, 2018
Last updated
Apr 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC10348 MD
Professional Counselor 101YP2500X LC10348 MD Primary

Addresses

Primary practice location

15602 Everglade LN Apt 303
Bowie, MD 20716-3245

Mailing address

15602 Everglade LN Apt 303
Bowie, MD 20716-3245
Phone (646) 244-7633

Other practice location 1

13102 Jordans Endeavor Dr
Bowie, MD 20720-3393
Phone (646) 244-7633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC10348MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1538630967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15602 EVERGLADE LN APT 303",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163245",
            "telephone_number": "646-244-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15602 EVERGLADE LN APT 303",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163245",
            "telephone_number": "646-244-7633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13102 Jordans Endeavor Dr",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207203393",
            "country_code": "US",
            "telephone_number": "646-244-7633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON MENDIE",
        "first_name": "CHONTELAI",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC10348",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC10348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.