Individual provider Active NPI

Elizabeth Leigh Mehaffey, LCMHC

  • Mental Health Counselor
  • Kernersville, NC
National Provider Identifier
1639603095
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12477 Issued in NC
Practice address
280 Broad St Ste E
Kernersville, NC 27284-2948
Phone
(336) 277-6050
Fax
(336) 992-3141
NPI assigned
Apr 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 12447 NC
Mental Health Counselor 101YM0800X A12477 NC
Mental Health Counselor 101YM0800X 12477 NC Primary

Addresses

Primary practice location

280 Broad St Ste E
Kernersville, NC 27284-2948

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

2031 Martin Luther King Jr Dr Ste E
Greensboro, NC 27406-3300
Phone (336) 271-5888

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
I20240312002299 NC Practitioner - Mental Health Counselor 0345686465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

13815 Professional Ctr Dr
Suite 100
Huntersville, NC 28078-7951
Phone (704) 384-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A12477NCMDMental Health Counselor
12447NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050

280 Broad St
Ste E
Kernersville, NC 27284
Phone (336) 277-6050

6620 Shallowford Rd
#200
Lewisville, NC 27023
Phone (336) 757-0258

309 Pineywood Rd
Thomasville, NC 27360
Phone (336) 474-8921

140 Kimel Park Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 718-7250

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

140 Kimel Park Dr
Ste 101
Winston Salem, NC 27103
Phone (336) 718-7280

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: familysolutions.elizabethmehaffey@148776.advancedmd-direct.com

Organizations & group practices 6

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1639603095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BROAD ST STE E",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842948",
            "telephone_number": "336-277-6050",
            "fax_number": "336-992-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2031 Martin Luther King Jr Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274063300",
            "country_code": "US",
            "telephone_number": "336-271-5888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHAFFEY",
        "first_name": "ELIZABETH",
        "middle_name": "LEIGH",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "12447",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A12477",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.