Michael Doughtie, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4324 Issued in NC

Practice address

215 Lafollette Dr
Winterville, NC 28590-9088

Phone

(252) 402-5693

Fax

(252) 355-2358

NPI assigned

Mar 6, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1942330675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 LAFOLLETTE DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909088",
            "telephone_number": "252-402-5693",
            "fax_number": "252-355-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 LAFOLLETTE DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909088",
            "telephone_number": "252-402-5693",
            "fax_number": "252-355-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHTIE",
        "first_name": "MICHAEL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "20-3675549",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102191",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "138UY",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "20-3675549",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ta'Nishia Jones Dixon, M.S.
• Kyle Dombach, PHARM.D.
• Denise K Donica, OT
• Dontaes House, LLC
• John Dougherty
• Dove United Counseling and Assessment Services
• Dr Kaitlyn Spencer DMD PLLC (Beacon Dental)
• Domika Dunn
• East Carolina University (ECU Pediatrics Family Autism Center)
• Eastern Carolina Case Management

• Mental Health Counselor in Winterville, NC
• Providers in Winterville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.