Individual provider Active NPI

Julie Simmons, LCMHC,LCAS,CCS

  • Professional Counselor
  • Wilmington, NC
National Provider Identifier
1619414349
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
13093 Issued in NC
Practice address
108 N Kerr Ave Ste C2
Wilmington, NC 28405-3439
Phone
(910) 540-6749
Fax
(910) 769-1772
NPI assigned
Jan 19, 2017
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 13093 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 21056 NC
Mental Health Counselor 101YM0800X 13093 NC
Professional Counselor 101YP2500X 13093 NC Primary

Addresses

Primary practice location

108 N Kerr Ave Ste C2
Wilmington, NC 28405-3439

Mailing address

3953B Market St
Wilmington, NC 28403-1403
Phone (910) 540-6749

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
I20240112003992 NC Practitioner - Mental Health Counselor 9638535065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

108 N Kerr Ave
C2
Wilmington, NC 28405-3439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21056NCMDAddiction (Substance Use Disorder) Counselor
13093NCMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Monumental Foundations LLC Professional CurrentSince Dec 1, 2023 Accepting new patients

Locations

108 N Kerr Ave
Ste C2
Wilmington, NC 28405
Phone (910) 540-6749

3953B Market St
Wilmington, NC 28403
Phone (910) 523-1825

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, 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": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1619414349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3953B MARKET ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031403",
            "telephone_number": "910-540-6749",
            "fax_number": "910-769-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N KERR AVE STE C2",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053439",
            "telephone_number": "910-540-6749",
            "fax_number": "910-769-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JULIE",
        "credential": "LCMHC,LCAS,CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "13093",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "21056",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13093",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "13093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.