Individual provider Active NPI

Luisa Alejandra Ydrovo

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1093225500
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A13579 Issued in NC
Practice address
2430 Reynolda Rd
Winston Salem, NC 27106-4626
Phone
(336) 291-7477
NPI assigned
Oct 10, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A13579 NC Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

2430 Reynolda Rd
Winston Salem, NC 27106-4626

Mailing address

264 Wood Duck Run
Lexington, NC 27295-8263
Phone (336) 880-0276

Other practice location 1

111 Mackenan Dr
Cary, NC 27511-7903
Phone (336) 880-0276

Other practice location 2

2499 Henning Dr
Winston Salem, NC 27106-4558
Phone (336) 624-6471

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

LicenseStateTypeSpecialty
A13579NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Christian Counseling, PLLC Professional PastSince Jun 20, 2016 Accepting new patients

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093225500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 WOOD DUCK RUN",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272958263",
            "telephone_number": "336-880-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 REYNOLDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064626",
            "telephone_number": "336-291-7477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Mackenan Dr",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275117903",
            "country_code": "US",
            "telephone_number": "336-880-0276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2499 Henning Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271064558",
            "country_code": "US",
            "telephone_number": "336-624-6471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YDROVO",
        "first_name": "LUISA",
        "middle_name": "ALEJANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13579",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 17, 2018; 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.