Individual provider Active NPI

Erin Tagge

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1023433125
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10230 Issued in NC
Practice address
175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951
Phone
(336) 718-3550
Fax
(336) 277-6981
NPI assigned
Feb 26, 2014
Last updated
May 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10230 NC Primary
Counselor 101Y00000X A10230 NC

Addresses

Primary practice location

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951

Mailing address

8313 Knight Village Cir
Stokesdale, NC 27357-9280

Other practice location 1

8313 Knight Village Cir
Stokesdale, NC 27357-9280
Phone (336) 643-4008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220000440 NC Practitioner - Mental Health Counselor 4688018591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Certus Psychiatry and Integrated Care PLLCGroup PAC ID 0244506756, 17 clinicians

Practice addresses (Care Compare)

1255 Creekshire Way
Suite 270
Winston Salem, NC 27103-3061
Phone (336) 701-3111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A10230NCMDCounselor
10230NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Certus Psychiatry and Integrated Care PLLC CurrentSince Feb 3, 2025 Accepting new patients

Locations

1255 Creekshire Way
Ste 270
Winston Salem, NC 27103
Phone (336) 701-3111

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1023433125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8313 KNIGHT VILLAGE CIR",
            "city": "STOKESDALE",
            "state": "NC",
            "postal_code": "273579280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 KIMEL PARK DR STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036951",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-6981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8313 Knight Village Cir",
            "address_purpose": "LOCATION",
            "city": "Stokesdale",
            "state": "NC",
            "postal_code": "273579280",
            "country_code": "US",
            "telephone_number": "336-643-4008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAGGE",
        "first_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10230",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A10230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.