Active NPI
Susan Mary Underhill, MA LPC
- Mental Health Counselor
- Wilmington, NC
National Provider Identifier
1568435535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11433
- Practice address
- 4020 Oleander Dr Ste 103
Wilmington, NC 28403-6800 - Phone
- (910) 218-8295
- Fax
- (910) 240-6595
- NPI assigned
- Feb 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2004020675 | MO | |
| Mental Health Counselor | 101YM0800X | 11433 | NC | Primary |
Addresses
Primary practice location
4020 Oleander Dr Ste 103
Wilmington, NC 28403-6800
Mailing address
4020 Oleander Dr Ste 103
Wilmington, NC 28403-6800
Phone (910) 218-8295
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 498353309 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 13, 2024 through Oct 13, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004020675 | MO | MD | Professional Counselor |
| 11433 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Susan Mary Underhill | Professional | Past | Accepting new patients |
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.
-
- Professional Counselor
- Saint Louis, MO
- NPI 1659661049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758499200000",
"number": "1568435535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 OLEANDER DR STE 103",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036800",
"telephone_number": "910-218-8295",
"fax_number": "910-240-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 OLEANDER DR STE 103",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036800",
"telephone_number": "910-218-8295",
"fax_number": "910-240-6595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERHILL",
"first_name": "SUSAN",
"middle_name": "MARY",
"name_prefix": "Mrs.",
"credential": "MA LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-09",
"last_updated": "2025-09-22",
"certification_date": "2025-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2004020675",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "11433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "498353309",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.