Individual provider Active NPI

Andrew Whittemore Daniel, LCMHCA

  • Mental Health Counselor
  • Cornelius, NC
National Provider Identifier
1659109833
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A20312 Issued in NC
Practice address
21024 Catawba Ave
Cornelius, NC 28031-8585
Phone
(336) 355-8084
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 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 CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X A20312 NC Primary

Addresses

Primary practice location

21024 Catawba Ave
Cornelius, NC 28031-8585

Mailing address

235 S Church St
Winston Salem, NC 27101-5305
Phone (336) 355-8084

Other names 1

  • Mr. Whitt Daniel Other name

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
A20312NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Camel City Counseling PLLC Mental Health CurrentSince Jul 28, 2024 Accepting new patients

Locations

235 S Church St
Winston Salem, NC 27101
Phone (336) 355-8084

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": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1659109833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S CHURCH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015305",
            "telephone_number": "336-355-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21024 CATAWBA AVE",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318585",
            "telephone_number": "336-355-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "ANDREW",
        "middle_name": "WHITTEMORE",
        "name_prefix": "Mr.",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WHITT",
            "last_name": "DANIEL",
            "prefix": "MR.",
            "credential": "LCMHCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.