Individual provider Active NPI

Michelle Lee Dunham

  • Mental Health Counselor
  • New Bern, NC
National Provider Identifier
1851773048
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A12163 Issued in NC
Practice address
1425 S Glenburnie Rd Ste 3
New Bern, NC 28562-2610
Phone
(252) 514-9888
Fax
(252) 648-6774
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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 LCAS-20064 NC
Mental Health Counselor 101YM0800X A12163 NC Primary

Addresses

Primary practice location

1425 S Glenburnie Rd Ste 3
New Bern, NC 28562-2610

Mailing address

2269 Stantonsburg Rd
Greenville, NC 27834-2841
Phone (252) 439-0700

Other identifiers 1

IdentifierTypeStateIssuer
1851773048MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
A12163NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Second Chance Behavioral Health Mental Health CurrentSince Jun 10, 2024 Accepting new patients
Integrated Family Services, PLLC Past Accepting new patients
Peter P Greco MD PastSince Jul 25, 2019 Accepting new patients

Locations

1425 S Glenburnie Rd
Ste 3
New Bern, NC 28562
Phone (252) 514-9888

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1851773048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2269 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342841",
            "telephone_number": "252-439-0700",
            "fax_number": "252-439-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S GLENBURNIE RD STE 3",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622610",
            "telephone_number": "252-514-9888",
            "fax_number": "252-648-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNHAM",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-20064",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A12163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851773048",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.