Shana Midgette, LCAS, LCMHC, LPA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6694 Issued in NC

Practice address

2424 Commerce Rd
Jacksonville, NC 28546-7505

Phone

(252) 557-0444

NPI assigned

Feb 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Positive Life Changes

  • Community/Behavioral Health Agency
  • Hookerton, NC
  • NPI 1750603288
  NPD Authorized official

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1659644383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 COMMERCE RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467505",
            "telephone_number": "252-557-0444",
            "fax_number": "252-557-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 COMMERCE RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467505",
            "telephone_number": "252-557-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 E. Main St.",
            "address_purpose": "LOCATION",
            "city": "Hookerton",
            "state": "NC",
            "postal_code": "285384901",
            "country_code": "US",
            "telephone_number": "252-557-0444",
            "fax_number": "252-557-0445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDGETTE",
        "first_name": "SHANA",
        "name_prefix": "Dr.",
        "credential": "LCAS, LCMHC, LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "1853",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "6694",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "1853",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1853",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112264",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelina H Therrien LCSW PA
• Kassondra Ann Michno, DMD
• Mid Atlantic Neurology & Sleep Medicine, P.a.
• Mid Atlantic Neurology & Sleep Medicine, P.a.
• Danajha Middleton
• Ashraf GB Mikhail, MD
• Fayez F Mikhail, M.D.
• Francis J Milewski, M.D.
• Military Supplemental Counseling Center, LLP
• Miller and Associates Three PLLC (Miller and Associates)

• Psychologist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.