Individual provider Active NPI

Melissa Kelly Benson, LCSW, LCAS

  • Clinical Social Worker
  • Gastonia, NC
National Provider Identifier
1609074111
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C00046 Issued in NC
Practice address
1337 E Garrison Blvd
Gastonia, NC 28054-5127
Phone
(704) 865-3848
Fax
(704) 854-3086
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1025 NC
Clinical Social Worker 1041C0700X C00046 NC Primary

Addresses

Primary practice location

1337 E Garrison Blvd
Gastonia, NC 28054-5127

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (048) 342-4507

Other identifiers 1

IdentifierTypeStateIssuer
6002717MedicaidNC

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
I20210408002788 NC Practitioner - Clinical Social Worker 9830507946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

1220 Spruce St
Belmont, NC 28012-3370
Phone (704) 825-5333

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C00046NCMDClinical Social Worker
1025NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Nov 4, 2024 Accepting new patients
Monarch CurrentSince Jul 1, 2022 Accepting new patients
Monarch Current Accepting new patients
Caromont Medical Group Inc CurrentSince Nov 4, 2024 Accepting new patients
Monarch CurrentSince Jul 1, 2022 Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

1337 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 671-5313

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

Organizations & group practices 6

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1609074111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "048-342-4507",
            "fax_number": "704-671-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127",
            "telephone_number": "704-865-3848",
            "fax_number": "704-854-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "MELISSA",
        "middle_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1025",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C00046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002717",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.