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SHASTA MINTON LCMHCA
NPI 1275142606
Counselor - Professional in Mooresville, NC

Active since July 31, 2020PECOS Enrolled
311 WILLIAMSON RD STE 103, MOORESVILLE, NC 28117(704) 360-3049 Get Directions Write a Review

NPPES record last updated: July 31, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Shasta Minton Lcmhca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHASTA MINTON LCMHCA (NPI 1275142606) is an individual professional provider in Mooresville, North Carolina and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275142606
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameSHASTA MINTONCredential: LCMHCA
Location Address311 WILLIAMSON RD STE 103Mooresville, NC 28117-5967
Mailing Address106 Shelburne PlMooresville, NC 28117-7306
Phone(704) 360-3049
Sole ProprietorYes
Enumeration DateJuly 31, 2020
NPPES CertifiedJuly 31, 2020
✔ NPI 1275142606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
311 WILLIAMSON RD STE 103, Mooresville, NC 28117
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shasta Minton Lcmhca is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shasta Minton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Telos Health Systems Nc PLLC
3.8 mi
Internal Medicine
550 GLENWOOD DR
Mooresville, NC 28115
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Vitae Health Medical North Carolina PLLC
  • 121 clinicians in this Medicare group
NPI 1265064414 (201) 217-6777

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA ROSE WING MA, LCMHCA, NCC
Counselor (Professional)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049
TETIANA MALKOVA
Counselor (Professional)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049
KENDALL CLAY
Counselor (Professional)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049
ALISA KAYE GIBSON RICHARD LCMHCA
Counselor (Professional)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049
DELIA VICIDOMINI LCMHCA
Counselor (Professional)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049
AMY MARIE RIECKEN MSW LCSW-A
Social Worker (Clinical)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049
CHARLOTTE COPPER LCMHC-A
Counselor (Professional)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049
CAROLINE PIERLE
Counselor (Professional)
311 WILLIAMSON RD STE 103
MOORESVILLE, NC 28117
Iredell County (704) 360-3049

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shasta Minton's NPI number?

The NPI number for Shasta Minton is 1275142606. It was assigned to this individual provider in the NPPES registry on July 31, 2020.

Where is Shasta Minton located?

Shasta Minton practices at 311 Williamson Rd Ste 103, Mooresville, NC 28117. The listed phone number is (704) 360-3049.

What is Shasta Minton's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Shasta Minton enrolled in Medicare?

Yes. Shasta Minton is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shasta Minton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shasta Minton reassigns Medicare benefits to Telos Health Systems Nc PLLC (Mooresville, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shasta Minton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shasta Minton was last updated on July 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.