Individual provider Active NPI

Leah Riddell

  • Mental Health Counselor
  • Greenville, NC
National Provider Identifier
1811537202
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCMHCA15523 Issued in NC
Practice address
704 Cromwell Dr Ste a
Greenville, NC 27858-5894
Phone
(252) 220-5896
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X LCAS25975 NC
Mental Health Counselor 101YM0800X LCMHCA15523 NC Primary

Addresses

Primary practice location

704 Cromwell Dr Ste a
Greenville, NC 27858-5894

Mailing address

704 Cromwell Dr Ste a
Greenville, NC 27858-5894
Phone (252) 220-5896

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

State licenses

LicenseStateTypeSpecialty
LCAS25975NCMDAddiction (Substance Use Disorder) Counselor
LCMHCA15523NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Origins Counseling and Wellness Addiction (Substance Use Disorder) Current Accepting new patients

Locations

702 Cromwell Dr
Ste C
Greenville, NC 27858
Phone (252) 258-0856

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.

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1811537202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 CROMWELL DR STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585894",
            "telephone_number": "252-220-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 CROMWELL DR STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585894",
            "telephone_number": "252-220-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDELL",
        "first_name": "LEAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS25975",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "LCMHCA15523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.