Individual provider Active NPI

Marlon Bentley Price Jr., LCMHC

  • Mental Health Counselor
  • Lexington, NC
National Provider Identifier
1740720663
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12654 Issued in NC
Practice address
820 Grimes Blvd
Lexington, NC 27292-7640
Phone
(336) 543-0436
NPI assigned
Feb 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A12654 NC
Mental Health Counselor 101YM0800X 12654 NC Primary

Addresses

Primary practice location

820 Grimes Blvd
Lexington, NC 27292-7640

Mailing address

124 Canterbury Rd
Reidsville, NC 27320-8317
Phone (336) 543-0436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231211001798 NC Practitioner - Mental Health Counselor 8022467406 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A12654NCMDProfessional Counselor
12654NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch CurrentSince Jan 1, 2024 Accepting new patients
Monarch CurrentSince Jan 1, 2024 Accepting new patients
Monarch Current Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

Organizations & group practices 3

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": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1740720663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 CANTERBURY RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208317",
            "telephone_number": "336-543-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 GRIMES BLVD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272927640",
            "telephone_number": "336-543-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "MARLON",
        "middle_name": "BENTLEY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-24",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A12654",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.