Derwin Samuel Isaiah II

Primary specialty

CounselorTaxonomy code 101Y00000X

License

10304 Issued in NC

Practice address

1914 Brunswick Ave Ste 1B
Charlotte, NC 28207-1891

Phone

(704) 281-6356

NPI assigned

Jun 12, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sankofa 34 Mens Healing Hub

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charlotte, NC
  • NPI 1427814383
  NPD Authorized official
• Isaiah Counseling & Wellness PLLC

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1114239134
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1013321629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 BRUNSWICK AVE STE 1B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071891",
            "telephone_number": "704-281-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 BRUNSWICK AVE STE 1B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071891",
            "telephone_number": "704-281-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAIAH",
        "first_name": "DERWIN",
        "middle_name": "SAMUEL",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "10304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Irwin
• Todd Andrew Irwin, MD
• Genesis Isaac
• Rachel Isaacs, RBT
• Isaiah Counseling & Wellness PLLC
• Shawntal M. Isaiah, LCSW
• Tommy Coble Ishee III, PSYD
• Chad Richard Ishmael, MD
• Zuhour Ishnaineh
• Dennis Isiguen, MD

• Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.