Victoria Baxter, LCMHC
Individual provider Active NPI Counselor · Raleigh, NC
NPI 1003365172 · NPPES record last updated Jul 16, 2020
Key facts
- NPI
- 1003365172
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 39 Red LN
Raleigh, NC 27606-1672 - Phone
- (706) 836-1713
- NPI assigned
- Sep 29, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231130000338 | NC | Practitioner - Mental Health Counselor | 8224486303 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14255 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thriveworks Clinical - North Carolina PC | Current |
Accepting new patients |
Locations
119 SW Maynard Rd
Cary, NC 27511
Phone (919) 415-1112
3111 Springbank Ln
Ste 1
Charlotte, NC 28226
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
39 Red LN
Raleigh, NC 27606-1672
Mailing address
39 Red LN
Raleigh, NC 27606-1672
Phone (706) 836-1713
Other practice location 1
223 N Anderson Dr
Swainsboro, GA 30401-4440
Phone (478) 289-2522
NPI Registry JSON
{
"created_epoch": "1475107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594857600000",
"number": "1003365172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 RED LN",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276061672",
"telephone_number": "706-836-1713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 RED LN",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276061672",
"telephone_number": "706-836-1713"
}
],
"practiceLocations": [
{
"address_1": "223 N Anderson Dr",
"address_purpose": "LOCATION",
"city": "Swainsboro",
"state": "GA",
"postal_code": "304014440",
"country_code": "US",
"telephone_number": "478-289-2522",
"fax_number": "478-289-2798",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAXTER",
"first_name": "VICTORIA",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-29",
"last_updated": "2020-07-16",
"certification_date": "2020-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.