Individual provider Active NPI

Dane Mullis

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1811859614
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
500 Archdale Dr
Charlotte, NC 28217-4217
Phone
(704) 332-9001
NPI assigned
Dec 1, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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) Counselor 101YA0400X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

500 Archdale Dr
Charlotte, NC 28217-4217

Mailing address

500 Archdale Dr
Charlotte, NC 28217-4217
Phone (704) 332-9001

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

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1811859614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ARCHDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174217",
            "telephone_number": "704-332-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ARCHDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174217",
            "telephone_number": "704-332-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "DANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Dec 1, 2025; 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.