MEDICARE: MOUNTAIN RIDGE COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1073487708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN RIDGE COUNSELING PLLC

Provider Business Mailing Address
First Line	:	PO BOX 114
Second Line	:
City	:	STATE ROAD
State	:	NC
Zip	:	28676-0114
Country	:	US
Telephone Number	:	336-569-4340
Fax Number	:

Provider Business Practice Location Address
First Line	:	6255 TOWNCENTER DR
Second Line	:	UNIT 1698
City	:	CLEMMONS
State	:	NC
Zip	:	27012
Country	:	US
Telephone Number	:	336-569-4340
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER/AUTHORIZED REP
Name	:	MELISSA CASSTEVENS
Credential	:
Telephone Number	:	336-466-7268

Provider Enumeration Date	:	10/04/2025
Last Update Date	:	12/04/2025

Similar Medicare Providers

1407739816 — PATHWAYS TO PEACE COUNSELING, PLLC
Practice Location Address:

3540 CLEMMONS RD STE 101
CLEMMONS, NC
27012-9396

Practice Phone: 336-223-6799
Practice Fax:

1497363956 — KELLY HAUHUTH SPOLORIC M.S. CCC-SLP
Practice Location Address:

5670 CLOUDS HARBOR TRAIL
CLEMMONS, NC
27012

Practice Phone: 336-407-0447
Practice Fax:

1952265480 — POPPY SPEECH LLC
Practice Location Address:

5670 CLOUDS HARBOR TRAIL
CLEMMONS, NC
27012

Practice Phone: 336-407-0447
Practice Fax:

1942164512 — MR. DYLAN WILLIAM CORTESE BS, MSPAS, PA-C
Practice Location Address:

2770 LEWISVILLE CLEMMONS RD
CLEMMONS, NC
27012-8716

Practice Phone: 336-766-0324
Practice Fax:

1740142538 — RACHEL SCHMIDT RN
Practice Location Address:

7144 VILLAGE MEDICAL CIR
CLEMMONS, NC
27012-8004

Practice Phone: 336-893-1436
Practice Fax: 336-893-1439

1659233443 — STACEY M LADD RN
Practice Location Address:

7144 VILLAGE MEDICAL CIR
CLEMMONS, NC
27012-8004

Practice Phone: 336-893-1437
Practice Fax: 336-893-1439

Directions to “MOUNTAIN RIDGE COUNSELING PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.