Individual provider Active NPI

Kara Mild, LCSW

  • Clinical Social Worker
  • Waxhaw, NC
National Provider Identifier
1720250657
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016613 Issued in NC
Practice address
1621 Providence Rd.
Suite 370
Waxhaw, NC 28173
Phone
(704) 520-7098
NPI assigned
Apr 1, 2008
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C016613 NC
Clinical Social Worker 1041C0700X C016613 NC Primary
Mental Health Counselor 101YM0800X CW015938 PA

Addresses

Primary practice location

1621 Providence Rd.
Suite 370
Waxhaw, NC 28173

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (919) 237-1625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080530000503 PA Practitioner - Clinical Social Worker 9133299357
I20240228001375 NC Practitioner - Clinical Social Worker 9133299357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

9805 Sandy Rock PL
Suite E
Charlotte, NC 28277-7731
Phone (980) 580-0468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW015938PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Mar 1, 2024 Accepting new patients
Dr Kara Mild Counseling PLLC Clinical Current Accepting new patients

Locations

9805 Sandy Rock Pl
Ste E
Charlotte, NC 28277
Phone (980) 580-0468

4705 University Dr
Bldg 700
Durham, NC 27707
Phone (919) 237-1337

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

1621 S Providence Rd
Ste 370
Waxhaw, NC 28173
Phone (704) 520-7089

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1720250657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 PROVIDENCE RD.",
            "address_2": "SUITE 370",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "28173",
            "telephone_number": "704-520-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILD",
        "first_name": "KARA",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C016613",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016613",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CW015938",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

Verify at the official NPI Registry.