Beverly Dyshanne Booker, LCMHA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A20095 Issued in NC

Practice address

3333 Brookview Hills Blvd Ste 205
Winston Salem, NC 27103-5661

Phone

(336) 261-6440

Fax

(336) 232-1436

NPI assigned

Oct 30, 2024

Sex

Female

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

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valera Counseling Services

  dba Valera Counseling Services, PLLC

  • Mental Health Counselor
  • Winston Salem, NC
  • NPI 1407335953
  Medicare reassignment NPD
• Safe Haven Autism and Behavioral Center

  • Community/Behavioral Health Agency
  • Winston Salem, NC
  • NPI 1447087887
  NPD

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1083436018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 GLENDARE CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044735",
            "telephone_number": "336-745-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BROOKVIEW HILLS BLVD STE 205",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035661",
            "telephone_number": "336-261-6440",
            "fax_number": "336-232-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "BEVERLY",
        "middle_name": "DYSHANNE",
        "name_prefix": "Mrs.",
        "credential": "LCMHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A20095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Dawn Bonnett, N.P
• Dean J Bonsall, M.D.
• Erin J Bonsall
• Richard Paul Bonsall, M.D.
• John Paul Bonvillian, DPM
• Darryl Booker II, PHARMD
• Allicia Booth, MS, CCC-SLP
• Kiana Louise Booth
• Margaret Elizabeth Booth, RPH
• Bret David Borchelt, MD

• Professional Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.