Individual provider Active NPI

William R. Powell, LCMHCS, NCC

  • Mental Health Counselor
  • Lillington, NC
National Provider Identifier
1902024029
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S6861 Issued in NC
Practice address
817 W Front St
Lillington, NC 27546-9735
Phone
(910) 814-2197
Fax
(910) 814-2167
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X S6861 NC Primary

Addresses

Primary practice location

817 W Front St
Lillington, NC 27546-9735

Mailing address

105 Mingocrest Dr
PO Box 242
Knightdale, NC 27545-7675
Phone (910) 814-2197

Other identifiers 1

IdentifierTypeStateIssuer
56621OtherNBCC

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
I20240319003929 NC Practitioner - Mental Health Counselor 5698112175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peace of Mind IncGroup PAC ID 4284992827, 4 clinicians

Practice addresses (Care Compare)

817 W Front St
Lillington, NC 27546-9735
Phone (910) 814-2197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S6861NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind, Inc. Professional CurrentSince Jan 30, 2024 Accepting new patients

Locations

817 W Front St
Lillington, NC 27546
Phone (910) 814-2197

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1902024029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MINGOCREST DR",
            "address_2": "PO BOX 242",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457675",
            "telephone_number": "910-814-2197",
            "fax_number": "910-814-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 W FRONT ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275469735",
            "telephone_number": "910-814-2197",
            "fax_number": "910-814-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "LCMHCS, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S6861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCC",
            "identifier": "56621",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

Verify at the official NPI Registry.