Active NPI
Marquita Shana Hill, LCMHCA
- Mental Health Counselor
- Mount Holly, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A16221
- Practice address
- 124 S Hawthorne St
Mt Holly, NC 28120-1663 - Phone
- (704) 874-9005
- NPI assigned
- Mar 4, 2018
- Last updated
- Jun 24, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 21615 | NC | |
| Mental Health Counselor | 101YM0800X | A16221 | NC | Primary |
Addresses
Primary practice location
124 S Hawthorne St
Mt Holly, NC 28120-1663
Mailing address
200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1900
Other practice location 1
5970 Fairview Rd Ste 126
Charlotte, NC 28210-2100
Phone (704) 762-1361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21615 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A16221 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gaston Family Health Services, Inc. | Current | Accepting new patients | |
| Bridges Therapeutic Services PLLC | Mental Health | Past | Accepting new patients |
Locations
200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904
124 S Hawthorne St
Mt Holly, NC 28120
Interoperability endpoints
- mhill722475@direct.ochin.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Kintegra at Mt Holly Middle
- Federally Qualified Health Center (FQHC)
- Mount Holly, NC
- NPI 1467201251
-
- Community/Behavioral Health Agency
- Charlotte, NC
- NPI 1306350012
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1962904102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E 2ND AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524358",
"telephone_number": "704-874-1900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 S HAWTHORNE ST",
"city": "MT HOLLY",
"state": "NC",
"postal_code": "281201663",
"telephone_number": "704-874-9005"
}
],
"practiceLocations": [
{
"address_1": "5970 Fairview Rd Ste 126",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282102100",
"country_code": "US",
"telephone_number": "704-762-1361",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HILL",
"first_name": "MARQUITA",
"middle_name": "SHANA",
"credential": "LCMHCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-04",
"last_updated": "2024-06-24",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "21615",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A16221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Holly, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.