Active NPI
Keeshma Richardson, LCMHCA, NCC
- Mental Health Counselor
- Charlotte, NC
National Provider Identifier
1629722053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A17332
- Practice address
- 2015 Ayrsley Town Blvd Ste 202
Charlotte, NC 28273-4068 - Phone
- (980) 533-0856
- NPI assigned
- Feb 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A17332 | NC | Primary |
Addresses
Primary practice location
2015 Ayrsley Town Blvd Ste 202
Charlotte, NC 28273-4068
Mailing address
PO Box 470783
Charlotte, NC 28247-0783
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
| License | State | Type | Specialty |
|---|---|---|---|
| A17332 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kay Counseling, PLLC | Mental Health | Current | 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.
-
- Mental Health Counselor
- Charlotte, NC
- NPI 1972104008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1629722053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 470783",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282470783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 AYRSLEY TOWN BLVD STE 202",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282734068",
"telephone_number": "980-533-0856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "KEESHMA",
"credential": "LCMHCA, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-04",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A17332",
"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 Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.