Individual provider Active NPI

Morgan Randleman

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1609670116
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A20683 Issued in NC
Practice address
6419 Bannington Rd Ste B
Charlotte, NC 28226-1341
Phone
(704) 533-5810
NPI assigned
Apr 3, 2025
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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 A20683 NC Primary

Addresses

Primary practice location

6419 Bannington Rd Ste B
Charlotte, NC 28226-1341

Mailing address

6419 Bannington Rd Ste B
Charlotte, NC 28226-1341
Phone (704) 705-8706

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
A20683NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1609670116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6419 BANNINGTON RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282261341",
            "telephone_number": "704-705-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6419 BANNINGTON RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282261341",
            "telephone_number": "704-533-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLEMAN",
        "first_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20683",
            "primary": true
        }
    ],
    "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 Apr 3, 2025; 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.