Richard Halliburton

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A11374 Issued in NC

Practice address

1122 Sam Newell Rd
Suite 112
Matthews, NC 28105-5015

Phone

(980) 292-3586

NPI assigned

Feb 26, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 22, 2024 through Jan 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Alliance Counseling and Training Center

  • Professional Counselor
  • Matthews, NC
  • NPI 1366834921

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1780076877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 SAM NEWELL RD",
            "address_2": "SUITE 112",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 SAM NEWELL RD",
            "address_2": "SUITE 112",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055015",
            "telephone_number": "980-292-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIBURTON",
        "first_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A11374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine J. Hall, LCSW
• David Hall, M.D.
• Kacie Lou Elizabeth Hall
• Nina Keith Hall, MD
• Jennifer Hallenbeck, MPT
• Olivia Hallingquest
• Leslie Hamlin, MD
• Sydney Anne Hammer
• Han O DDS and M Reimels DDS PLLC
• Hand in Hand Speech Consulting PLLC

• Mental Health Counselor in Matthews, NC
• Providers in Matthews, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.