Individual provider Active NPI

Christine Marie Enderlin Lcmhc, LCMHC

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1548528177
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10369 Issued in NC
Practice address
2222 S College Rd
Wilmington, NC 28403-5545
Phone
(910) 798-6467
Fax
(910) 798-6411
NPI assigned
May 2, 2012
Last updated
Oct 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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 10369 NC Primary

Addresses

Primary practice location

2222 S College Rd
Wilmington, NC 28403-5545

Mailing address

2222 S College Rd
Wilmington, NC 28403-5545
Phone (910) 798-6467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123001369 NC Practitioner - Mental Health Counselor 7416309794

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1650 Greenfield St
Wilmington, NC 28401-6456

2222 S College Rd
Wilmington, NC 28403-5545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10369NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Hanover County Current Accepting new patients

Locations

1650 Greenfield St
Wilmington, NC 28401
Phone (910) 798-3500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1548528177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035545",
            "telephone_number": "910-798-6467",
            "fax_number": "910-798-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035545",
            "telephone_number": "910-798-6467",
            "fax_number": "910-798-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDERLIN LCMHC",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.