Individual provider Active NPI

Wesley Swan, LCMHC

  • Mental Health Counselor
  • Greensboro, NC
National Provider Identifier
1578062287
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13323 Issued in NC
Practice address
510 N Elam Ave Ste 302
Greensboro, NC 27403-1142
Phone
(336) 832-1368
Fax
(336) 832-1369
NPI assigned
Feb 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 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 13323 NC Primary

Addresses

Primary practice location

510 N Elam Ave Ste 302
Greensboro, NC 27403-1142

Mailing address

1633 New Garden Rd Ste 1131
Greensboro, NC 27410-2001
Phone (919) 521-7288

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
I20240305001736 NC Practitioner - Mental Health Counselor 3870938400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of North Carolina at Chapel Hill School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical of New Jersey PCGroup PAC ID 5799141750, 61 clinicians

Practice addresses (Care Compare)

3064 Wake Forest Rd
Suite 1271
Raleigh, NC 27609-7844
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13323NCMDPharmacist

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.

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1578062287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 NEW GARDEN RD STE 1131",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102001",
            "telephone_number": "919-521-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N ELAM AVE STE 302",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031142",
            "telephone_number": "336-832-1368",
            "fax_number": "336-832-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "WESLEY",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-08",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.