Individual provider Active NPI

Maegan Abigail Gillis, LCMHC

  • Mental Health Counselor
  • Boonville, NC
National Provider Identifier
1831890615
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A18412 Issued in NC
Practice address
2516 Longtown Rd
Boonville, NC 27011-8862
Phone
(336) 551-1150
Fax
(336) 551-1153
NPI assigned
Mar 17, 2023
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A18412 NC
Mental Health Counselor 101YM0800X A18412 NC Primary

Addresses

Primary practice location

2516 Longtown Rd
Boonville, NC 27011-8862

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1936

Other practice location 1

409 S Oakland St
Gastonia, NC 28052-4312
Phone (704) 874-9005

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
I20260325002106 NC Practitioner - Mental Health Counselor 9830673086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 E 2ND Ave
Gastonia, NC 28052-4358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A18412NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc. CurrentSince Nov 24, 2025 Accepting new patients
Gaston Family Health Services, Inc. PastSince Jun 18, 2023 Accepting new patients

Locations

2516 Longtown Rd
Boonville, NC 27011
Phone (336) 551-1150

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

Interoperability endpoints

  • Direct secure messaging: agillis649551@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1831890615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1936",
            "fax_number": "704-865-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 LONGTOWN RD",
            "city": "BOONVILLE",
            "state": "NC",
            "postal_code": "270118862",
            "telephone_number": "336-551-1150",
            "fax_number": "336-551-1153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 S Oakland St",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280524312",
            "country_code": "US",
            "telephone_number": "704-874-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "MAEGAN",
        "middle_name": "ABIGAIL",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A18412",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, NC

Sources for this page

Verify at the official NPI Registry.