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MIJIN WALL
NPI 1417568452
Counselor - Professional in Albemarle, NC

Active since August 13, 2020Opted out of Medicare · through Mar 19, 2028
2620 W MAIN ST, ALBEMARLE, NC 28001(980) 581-8144 Get Directions Write a Review

NPPES record last updated: August 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mijin Wall NPPES

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

MIJIN WALL (NPI 1417568452) is an individual professional provider in Albemarle, North Carolina, licensed in North Carolina (A15832) and active in the NPI registry since August 2020. She has opted out of Medicare through March 19, 2028.

NPPES Registry Identity

NPI1417568452
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMIJIN WALL
Location Address2620 W MAIN STAlbemarle, NC 28001-7457
Mailing Address2620 W Main StAlbemarle, NC 28001-7457 · (980) 581-8144
Phone(980) 581-8144
Sole ProprietorYes
Enumeration DateAugust 13, 2020
NPPES CertifiedAugust 13, 2020
✔ NPI 1417568452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in NC · A15832
2620 W MAIN ST, Albemarle, NC 28001
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mijin Wall has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 19, 2024 through March 19, 2028.

Opt-Out Effective DateMarch 19, 2024
Opt-Out In Effect ThroughMarch 19, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 13

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

MS. LAURA RAEUNN MARIE HARBESON PHD, LCMHCS, NCC
Counselor (Professional)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144
JENNIFER ANNE JOYNER LPC
Counselor (Professional)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144
MITCHELL CROOT
Counselor (Mental Health)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144
LYNN THOMAS
Counselor (Professional)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144
KRISTIN ELIZABETH BROWN LPCA, NCC
Counselor (Professional)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144
EDITH ANN TODD
Counselor (Mental Health)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144
KELLI ANNETTE PINION LCMHCA
Counselor (Professional)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144
KRISTA PETERSON MA, LCMHCA
Counselor (Mental Health)
2620 W MAIN ST
ALBEMARLE, NC 28001
Stanly County (980) 581-8144

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 Mijin Wall's NPI number?

The NPI number for Mijin Wall is 1417568452. It was assigned to this individual provider in the NPPES registry on August 13, 2020.

Where is Mijin Wall located?

Mijin Wall practices at 2620 W Main St, Albemarle, NC 28001. The listed phone number is (980) 581-8144.

What is Mijin Wall's specialty?

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

Is Mijin Wall enrolled in Medicare?

No. Mijin Wall has opted out of Medicare through March 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Mijin Wall accept?

Health plans from Blue Cross and Blue Shield of NC list Mijin Wall as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mijin Wall was last updated on August 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.