Individual provider Active NPI

Matthew Christopher Miller, LPC, LCMHC

  • Community/Behavioral Health Agency
  • Leland, NC
National Provider Identifier
1629600374
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
12735 Issued in NC
Practice address
4846 Sequoyah Lake CV
Leland, NC 28451-6524
Phone
(717) 634-1090
NPI assigned
Feb 11, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 12735 NC
Mental Health Counselor 101YM0800X 12735 NC
Community/Behavioral Health Agency 251S00000X 12735 NC Primary

Addresses

Primary practice location

4846 Sequoyah Lake CV
Leland, NC 28451-6524

Mailing address

1768 Lejack Cir
Forest, VA 24551-1274
Phone (717) 634-1090

Other identifiers 1

IdentifierTypeStateIssuer
12735OtherNCLCMHC

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
I20241223000426 NC Practitioner - Mental Health Counselor 2668909144 Practice locations: Huntersville, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12735NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew C Miller Dba Cornelius Christian Counseling Mental Health CurrentSince Feb 17, 2017 Accepting new patients

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": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1629600374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 LEJACK CIR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245511274",
            "telephone_number": "717-634-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4846 SEQUOYAH LAKE CV",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516524",
            "telephone_number": "717-634-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTOPHER",
        "credential": "LPC, LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-11",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "12735",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12735",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "12735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCMHC",
            "identifier": "12735",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.