Individual provider Active NPI

Maria Leo, LMFTA

  • Marriage & Family Therapist
  • Mooresville, NC
National Provider Identifier
1801491667
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
311 Williamson Rd Ste 103
Mooresville, NC 28117-5967
Phone
(704) 360-3049
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

311 Williamson Rd Ste 103
Mooresville, NC 28117-5967

Mailing address

4885 Patterson Rd
China Grove, NC 28023-7749
Phone (704) 640-4886

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
I20240508001372 NC Practitioner - Marriage and Family Therapist 6901247907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Counseling Associates at the Lake IncGroup PAC ID 4284953530, 5 clinicians

Practice addresses (Care Compare)

19501 W Catawba Ave
Mailbox 10
Cornelius, NC 28031-4017
Phone (704) 301-5424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2378NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates at the Lake, Inc. CurrentSince Apr 23, 2024 Accepting new patients
Thrive Counseling and Wellness, PLLC Marriage & Family Therapist CurrentSince Dec 6, 2020 Accepting new patients

Locations

19501 W Catawba Ave
Ste MB10
Cornelius, NC 28031

19501 W Catawba Ave
Ste 10
Cornelius, NC 28031
Phone (704) 301-5424

311 Williamson Rd
Ste 103
Mooresville, NC 28117
Phone (704) 360-3049

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1801491667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 PATTERSON RD",
            "city": "CHINA GROVE",
            "state": "NC",
            "postal_code": "280237749",
            "telephone_number": "704-640-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WILLIAMSON RD STE 103",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175967",
            "telephone_number": "704-360-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEO",
        "first_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.