Individual provider Active NPI

Mary Krenzel, LCMHC

  • Professional Counselor
  • Wilmington, NC
National Provider Identifier
1619252079
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12249 Issued in NC
Practice address
6209 Oleander Dr Ste 102
Wilmington, NC 28403-3582
Phone
(910) 777-8483
NPI assigned
Oct 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 12249 NC Primary

Addresses

Primary practice location

6209 Oleander Dr Ste 102
Wilmington, NC 28403-3582

Mailing address

1211 Cross Water Cir
Leland, NC 28451-1519
Phone (248) 835-5175

Other names 1

  • Mary R Krenzel Professional name

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
I20240801002214 NC Practitioner - Mental Health Counselor 1658818125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3722 Shipyard Blvd
Suite a
Wilmington, NC 28403-6165
Phone (910) 777-8493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12249NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Counseling and Wellness Professional CurrentSince Jul 6, 2024 Accepting new patients

Locations

3722 Shipyard Blvd
Ste A
Wilmington, NC 28403
Phone (910) 343-8988

6209 Oleander Dr
Ste 102
Wilmington, NC 28403
Phone (910) 777-8483

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": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1619252079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 CROSS WATER CIR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284511519",
            "telephone_number": "248-835-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 OLEANDER DR STE 102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033582",
            "telephone_number": "910-777-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRENZEL",
        "first_name": "MARY",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "12249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KRENZEL",
            "middle_name": "R",
            "credential": "LMCHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.