Individual provider Active NPI

Melissa Kemlage, M.ED LCMHC

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1861779993
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15209 Issued in NC
Practice address
4900 Randall Pkwy Ste J
Wilmington, NC 28403-2831
Phone
(910) 216-9113
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 15209 NC
Mental Health Counselor 101YM0800X 15209 NC Primary

Addresses

Primary practice location

4900 Randall Pkwy Ste J
Wilmington, NC 28403-2831

Mailing address

4900 Randall Pkwy Ste J
Wilmington, NC 28403-2831
Phone (910) 216-9113

Other practice location 1

3825 Market St Ste 4
Wilmington, NC 28403-1426
Phone (910) 777-5575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 1, 2026 through May 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15209NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peaceful Balance Counseling, PLLC CurrentSince Apr 24, 2022 Accepting new patients

Locations

4900 Randall Pkwy
Ste J
Wilmington, NC 28403
Phone (910) 216-9113

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": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1861779993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 RANDALL PKWY STE J",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032831",
            "telephone_number": "910-216-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 RANDALL PKWY STE J",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032831",
            "telephone_number": "910-216-9113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3825 Market St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284031426",
            "country_code": "US",
            "telephone_number": "910-777-5575",
            "fax_number": "910-777-5273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEMLAGE",
        "first_name": "MELISSA",
        "credential": "M.ED LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "15209",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.