Individual provider Active NPI

Emily Charlotte Gabrielle Waun, NCC, LCMHCA

  • Mental Health Counselor
  • Jacksonville, NC
National Provider Identifier
1649018565
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A20061 Issued in NC
Practice address
192 Village Dr
Jacksonville, NC 28546-7299
Phone
(910) 577-1400
NPI assigned
Jul 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A20061 NC Primary

Addresses

Primary practice location

192 Village Dr
Jacksonville, NC 28546-7299

Mailing address

816 Welton Cir
Jacksonville, NC 28546-7345
Phone (910) 787-6711

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

LicenseStateTypeSpecialty
A20061NCMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1649018565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 WELTON CIR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467345",
            "telephone_number": "910-787-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 VILLAGE DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467299",
            "telephone_number": "910-577-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUN",
        "first_name": "EMILY",
        "middle_name": "CHARLOTTE GABRIELLE",
        "credential": "NCC, LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.