Individual provider Active NPI

Michael Headen

  • Mental Health Counselor
  • Goldsboro, NC
National Provider Identifier
1972631810
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14451 Issued in NC
Practice address
696 N Spence Ave Ste a
Goldsboro, NC 27534-4354
Phone
(919) 330-4147
Fax
(919) 330-4142
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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 14451 NC Primary

Addresses

Primary practice location

696 N Spence Ave Ste a
Goldsboro, NC 27534-4354

Mailing address

1706 Wayne Memorial Dr
Goldsboro, NC 27534-2240
Phone (919) 734-6676

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
I20250327003887 NC Practitioner - Mental Health Counselor 4789107954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Campbell Univ School of Osteopathic Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simplicity Counseling Services PLLCGroup PAC ID 6103173737, 3 clinicians

Practice addresses (Care Compare)

696 N Spence Ave
Suite a
Goldsboro, NC 27534-4354
Phone (919) 330-4347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14451NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Simplicity Counseling Services PLLC Mental Health CurrentSince Jan 13, 2025 Accepting new patients
Waynesboro Family Clinic Mental Health PastSince Jun 25, 2007 Accepting new patients
Wayne Cares Inc. Past Accepting new patients

Locations

696 N Spence Ave
Ste A
Goldsboro, NC 27534
Phone (919) 330-4147

Organizations & group practices 3

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1972631810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342240",
            "telephone_number": "919-734-6676",
            "fax_number": "919-734-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 N SPENCE AVE STE A",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344354",
            "telephone_number": "919-330-4147",
            "fax_number": "919-330-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADEN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.