NPIMap

Organization Active NPI

Clear Creek Counseling and Consulting PC

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1891110060
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CLEAR CREEK COUNSELING AND CONSULTING PC
Practice address
1905 JN Pease PL
Suite 101
Charlotte, NC 28262
Phone
(980) 395-3062
Fax
(980) 321-7164
NPI assigned
Feb 25, 2014
Last updated
Sep 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Mr. Lonnie Mullet, LPCNPI 1831402551
Title
Director
Phone
(980) 430-4972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

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

Addresses

Primary practice location

1905 JN Pease PL
Suite 101
Charlotte, NC 28262

Mailing address

1905 J N Pease PL Ste 101
Charlotte, NC 28262-4516
Phone (980) 395-3062

Other identifiers 1

IdentifierTypeStateIssuer
6104525MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251010001622 NC Part B Supplier - Clinic/Group Practice 9739686031 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

1905 J N Pease Pl
Ste 101
Charlotte, NC 28262
Phone (980) 395-3062

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1891110060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 J N PEASE PL STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624516",
            "telephone_number": "980-395-3062",
            "fax_number": "980-321-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 JN PEASE PL",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28262",
            "telephone_number": "980-395-3062",
            "fax_number": "980-321-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR CREEK COUNSELING AND CONSULTING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "MULLET",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "980-430-4972",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104525",
            "state": "NC"
        }
    ],
    "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 Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.