Individual provider Active NPI

Lynne Midgett Wilkerson, LCMHC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1689256018
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15403 Issued in NC
Practice address
3315 Springbank LN Ste 106
Charlotte, NC 28226-3198
Phone
(704) 763-7056
Fax
(980) 819-5798
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 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 15403 NC Primary

Addresses

Primary practice location

3315 Springbank LN Ste 106
Charlotte, NC 28226-3198

Mailing address

5624 Lancelot Dr
Charlotte, NC 28270-0424
Phone (704) 763-7056

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

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1689256018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5624 LANCELOT DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282700424",
            "telephone_number": "704-763-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 SPRINGBANK LN STE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263198",
            "telephone_number": "704-763-7056",
            "fax_number": "980-819-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "LYNNE",
        "middle_name": "MIDGETT",
        "name_prefix": "Mrs.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-03-27",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.