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BRIAN DISTASO LCMHC
NPI 1528890704
Counselor - Mental Health in Matthews, NC

Active since August 16, 2024PECOS EnrolledAccepts Medicare Assignment
855 SAM NEWELL RD STE 100, MATTHEWS, NC 28105(704) 360-3637 Get Directions Write a Review

NPPES record last updated: October 10, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2024, Sep 25, 2024, Aug 16, 2024 (3 updates tracked since 2024).

About Brian Distaso Lcmhc NPPES

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

BRIAN DISTASO LCMHC (NPI 1528890704) is an individual mental health provider in Matthews, North Carolina, licensed in North Carolina (17591) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mint Hill, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1528890704
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameBRIAN DISTASOCredential: LCMHC
Location Address855 SAM NEWELL RD STE 100Matthews, NC 28105-7593
Mailing Address6016 Storehouse RdMint Hill, NC 28227-9294
Phone(704) 360-3637
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateAugust 16, 2024
Last NPPES UpdateOctober 10, 20243 updates tracked since enumeration
NPPES CertifiedOctober 10, 2024
✔ NPI 1528890704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · 17591
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 17591 (NC)
855 SAM NEWELL RD STE 100, Matthews, NC 28105
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Secondary Practice Location 1

Location 14732 Lebanon Rd Ste CMint Hill, NC 28227-9112 · Phone (980) 298-7302

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brian Distaso Lcmhc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567998289
PECOS Enrollment IDI20241204004517
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.

Other Providers at the Same Location NPPES 8

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

ESTHER NAM LCMHC
Counselor (Mental Health)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637
GAVIN THEOFIELD LCSW
Social Worker (Clinical)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637
JIWOO KIM LCSWA
Social Worker (Clinical)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637
ADREAN COTTLE LCMHC
Counselor (Mental Health)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637
CHIANTI SHANTEL LEAK LCSW
Social Worker (Clinical)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637
CHARITY ANN MATHEWS LCSWA, SSWS, MSW
Social Worker (Clinical)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637
ANDREA WEAVER LCMHC, NCC, LCASA
Counselor (Mental Health)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637
SHANTELE K WEAVER LPC
Counselor (Mental Health)
855 SAM NEWELL RD STE 100
MATTHEWS, NC 28105
Mecklenburg County (704) 360-3637

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 Brian Distaso's NPI number?

The NPI number for Brian Distaso is 1528890704. It was assigned to this individual provider in the NPPES registry on August 16, 2024.

Where is Brian Distaso located?

Brian Distaso practices at 855 Sam Newell Rd Ste 100, Matthews, NC 28105. The listed phone number is (704) 360-3637.

What is Brian Distaso's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Brian Distaso enrolled in Medicare?

Yes. Brian Distaso is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Brian Distaso was last updated on October 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.