Individual provider Active NPI

Heather Christine Quinlan, LCMHCA

  • Mental Health Counselor
  • Statesville, NC
National Provider Identifier
1679185953
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A15936 Issued in NC
Practice address
209 Barium Springs Dr
Statesville, NC 28677-8454
Phone
(704) 832-2200
Fax
(704) 838-1541
NPI assigned
Aug 19, 2020
Last updated
Aug 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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 A15936 NC Primary

Addresses

Primary practice location

209 Barium Springs Dr
Statesville, NC 28677-8454

Mailing address

PO Box 1
Barium Springs, NC 28010-0001
Phone (704) 832-2200

Other identifiers 1

IdentifierTypeStateIssuer
A15936OtherNCLICENSE

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
A15936NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1679185953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "BARIUM SPRINGS",
            "state": "NC",
            "postal_code": "280100001",
            "telephone_number": "704-832-2200",
            "fax_number": "704-838-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 BARIUM SPRINGS DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286778454",
            "telephone_number": "704-832-2200",
            "fax_number": "704-838-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINLAN",
        "first_name": "HEATHER",
        "middle_name": "CHRISTINE",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A15936",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.