Active NPI
Michele Robin Hairston, LCPA
- Professional Counselor
- Winston Salem, NC
National Provider Identifier
1043675671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12063
- Practice address
- 2430 Reynolda Rd Ste 2B
Winston Salem, NC 27106-4626 - Phone
- (336) 291-7477
- Fax
- (336) 217-8044
- NPI assigned
- Dec 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A12063 | NC | Primary |
Addresses
Primary practice location
2430 Reynolda Rd Ste 2B
Winston Salem, NC 27106-4626
Mailing address
PO Box 1083
Lewisville, NC 27023-1083
Phone (336) 291-7477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043675671 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12063 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faithful Living Foundation | Professional | Current | Accepting new patients |
| Faith First Christian Counseling | Professional | Current | Accepting new patients |
| Teladoc Health Medical Group, P.a. | Professional | Current | Accepting new patients |
| Trinity Christian Counseling, PLLC | Professional | Past | Accepting new patients |
Locations
223 N Main St
Walnut Cove, NC 27052
Phone (336) 310-5095
Interoperability endpoints
- michelehairston@tdh.allscriptsdirect.net
Organizations & group practices 4
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.
-
- Mental Health Counselor
- Walnut Cove, NC
- NPI 1285235382
Professional
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Professional
-
- Professional Counselor
- Winston Salem, NC
- NPI 1518317767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490745600000",
"number": "1043675671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1083",
"city": "LEWISVILLE",
"state": "NC",
"postal_code": "270231083",
"telephone_number": "336-291-7477",
"fax_number": "336-217-8044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2430 REYNOLDA RD STE 2B",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271064626",
"telephone_number": "336-291-7477",
"fax_number": "336-217-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAIRSTON",
"first_name": "MICHELE",
"middle_name": "ROBIN",
"credential": "LCPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-26",
"last_updated": "2017-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12063",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1043675671",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.