Alexandria Widener, LCMHCA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A17915 Issued in NC

Practice address

769 N Wendover Rd
Charlotte, NC 28211-1118

Phone

(704) 376-7180

Fax

(704) 531-9266

NPI assigned

Aug 4, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pediatric and Family Behavioral Health Acquisition Group PLLC

  • Psychiatry Physician
  • Charlotte, NC
  • NPI 1770056038
  Medicare reassignment NPD

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1558098004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E UNION ST",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281031246",
            "telephone_number": "276-206-4132",
            "fax_number": "704-531-9266"
        },
        {
            "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",
            "fax_number": "704-531-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDENER",
        "first_name": "ALEXANDRIA",
        "name_prefix": "Ms.",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A17915",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Jonina Wickham
• Ashley Case Wickline
• Wickshire Steele Creek Opco, LLC
• Jeffrey S. Widelitz, MD
• Chantel Wideman
• Robert Edward Widis, DDS
• Monica Widmeyer
• Nicholas Wieczorek, MD
• Jean L Wiegand, CRNA
• Craig Wiehe Jr., DPT

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.