Individual provider Active NPI

Danielle P. Kim, LHMHC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1861993511
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4111E Rose Lake Dr # 7888
Charlotte, NC 28217-2858
Phone
(828) 278-8262
NPI assigned
Feb 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 A13765 NC
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4111E Rose Lake Dr # 7888
Charlotte, NC 28217-2858

Mailing address

4111E Rose Lake Dr # 7888
Charlotte, NC 28217-2858
Phone (828) 278-8262

Other names 1

  • Danielle Minter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A13765NCMDProfessional Counselor
13765NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Waves Therapy LLC CurrentSince Jan 26, 2025 Accepting new patients
Wellmood PLLC PastSince Jan 1, 2024 Accepting new patients

Organizations & group practices 2

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": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1861993511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111E ROSE LAKE DR # 7888",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172858",
            "telephone_number": "828-278-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111E ROSE LAKE DR # 7888",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172858",
            "telephone_number": "828-278-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIELLE",
        "middle_name": "P.",
        "name_prefix": "Mrs.",
        "credential": "LHMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13765",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "MINTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.