Individual provider Active NPI

Shamanda Shanta Burston, LCMHC, LCAS

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1902296445
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
18257 Issued in NC
Practice address
1235 East Blvd
Charlotte, NC 28203-5870
Phone
(980) 440-3513
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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-21626 NC
Mental Health Counselor 101YM0800X 18257 NC Primary

Addresses

Primary practice location

1235 East Blvd
Charlotte, NC 28203-5870

Mailing address

1235 East Blvd
Charlotte, NC 28203-5870

Other identifiers 2

IdentifierTypeStateIssuer
18257OtherNCLCMHC
LCAS-21626OtherNCNORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL BOARD

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
I20240422002710 NC Practitioner - Mental Health Counselor 8022457175 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-21626NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jul 20, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Mar 10, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 20, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Mar 10, 2024 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients

Locations

501 Billingsley Rd
Charlotte, NC 28211
Phone (704) 358-2700

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

447 McAlister Rd
Ste 3300
Lincolnton, NC 28092
Phone (980) 212-2680

Organizations & group practices 7

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": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1902296445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035870",
            "telephone_number": "980-440-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSTON",
        "first_name": "SHAMANDA",
        "middle_name": "SHANTA",
        "name_prefix": "Dr.",
        "credential": "LCMHC, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21626",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "18257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCMHC",
            "identifier": "18257",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL BOARD",
            "identifier": "LCAS-21626",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.