Active NPI
Caitlin Clendenin, MA, LCMHCA
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1801616156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A20669
- Practice address
- 6911 Shannon Willow Rd Ste 500
Charlotte, NC 28226-1351 - Phone
- (704) 412-8361
- NPI assigned
- Oct 11, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A20669 | NC | Primary |
Addresses
Primary practice location
6911 Shannon Willow Rd Ste 500
Charlotte, NC 28226-1351
Mailing address
6610 Reafield Dr Apt 8
Charlotte, NC 28226-4569
Phone (910) 603-1412
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A20669 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgebuilder Ministries International | Professional | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Whispering Pines, NC
- NPI 1124995816
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1801616156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6610 REAFIELD DR APT 8",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282264569",
"telephone_number": "910-603-1412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6911 SHANNON WILLOW RD STE 500",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282261351",
"telephone_number": "704-412-8361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLENDENIN",
"first_name": "CAITLIN",
"credential": "MA, LCMHCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-11",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A20669",
"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 Oct 11, 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.