Organization Active NPI

Mentable

  • Adult Mental Health Clinic/Center
  • Charlotte, NC
National Provider Identifier
1609635895
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MENTABLE
Practice address
8401 Medical Plaza Dr Ste 350
Charlotte, NC 28262-8700
Phone
(980) 223-4566
Fax
(980) 500-1522
NPI assigned
Mar 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Camellia DouglasNPI 1114445905
Title
Owner/Provider
Phone
(877) 306-1683

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

8401 Medical Plaza Dr Ste 350
Charlotte, NC 28262-8700

Mailing address

8401 Medical Plaza Dr Ste 350
Charlotte, NC 28262-8700
Phone (877) 306-1683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240723000273 NC Part B Supplier - Clinic/Group Practice 6608312053 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

525 N Tryon St
Ste 1500
Charlotte, NC 28202

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1609635895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 MEDICAL PLAZA DR STE 350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628700",
            "telephone_number": "877-306-1683",
            "fax_number": "980-500-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MEDICAL PLAZA DR STE 350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628700",
            "telephone_number": "980-223-4566",
            "fax_number": "980-500-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTABLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "CAMELLIA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "877-306-1683"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.