Individual provider Active NPI

Malissa Truesdale-Crawford, LPC

  • Mental Health Counselor
  • Waxhaw, NC
National Provider Identifier
1598433807
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9097 Issued in SC
Practice address
104 Waxhaw Professional Park Dr Ste D
Waxhaw, NC 28173-5020
Phone
(980) 368-0323
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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 A17097 NC
Mental Health Counselor 101YM0800X 9097 SC Primary

Addresses

Primary practice location

104 Waxhaw Professional Park Dr Ste D
Waxhaw, NC 28173-5020

Mailing address

4251 S Rhett Ave Unit 5207
North Charleston, SC 29405-6911
Phone (803) 804-5199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A17097NCMDMental Health Counselor
9097SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
True Mental Wellness Counseling & Consulting Mental Health CurrentSince Nov 5, 2023 Accepting new patients
Thrive Family Services Mental Health PastSince Sep 1, 2021 Accepting new patients

Locations

104 Waxhaw Professional Park Dr
Ste D
Waxhaw, NC 28173
Phone (704) 748-0735

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": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1598433807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 S RHETT AVE UNIT 5207",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294056911",
            "telephone_number": "803-804-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WAXHAW PROFESSIONAL PARK DR STE D",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281735020",
            "telephone_number": "980-368-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUESDALE-CRAWFORD",
        "first_name": "MALISSA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17097",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "9097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.