Individual provider Active NPI

Marnda Nicole Leverette, LCMHC & LPC

  • Mental Health Counselor
  • Maynard, MA
National Provider Identifier
1548834658
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
16440 Issued in NC
Practice address
141 Parker St Ste 306
Maynard, MA 01754-2180
Phone
(866) 991-2103
NPI assigned
May 14, 2021
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 16440 NC Primary
Professional Counselor 101YP2500X 11521 SC

Addresses

Primary practice location

141 Parker St Ste 306
Maynard, MA 01754-2180

Mailing address

141 Parker St Ste 306
Maynard, MA 01754-2180
Phone (866) 991-2103

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
I20241205003017 NC Practitioner - Mental Health Counselor 3173059763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical North Carolina PLLCGroup PAC ID 7719317932, 41 clinicians

Practice addresses (Care Compare)

550 Glenwood Dr
Mooresville, NC 28115-2876
Phone (704) 664-7494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
16440NCMDMental Health Counselor
11521SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Telos Health Systems NC PLLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

500 Beaverdam Rd
Asheville, NC 28804
Phone (313) 318-1632

550 Glenwood Dr
Mooresville, NC 28115
Phone (704) 644-4797

1000 College St
Wilkesboro, NC 28697
Phone (336) 838-4141

Organizations & group practices 2

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": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1548834658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 PARKER ST STE 306",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017542180",
            "telephone_number": "866-991-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 PARKER ST STE 306",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017542180",
            "telephone_number": "866-991-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERETTE",
        "first_name": "MARNDA",
        "middle_name": "NICOLE",
        "credential": "LCMHC & LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "16440",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "11521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maynard, MA

Sources for this page

Verify at the official NPI Registry.