Patrick Travis Woodruff, MA, LCMHC, LCAS, CSI

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

14792 Issued in NC

Practice address

246A S Main St
Marion, NC 28752-4551

Phone

(252) 559-2882

NPI assigned

Mar 19, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Real Therapies & Wellness, PLLC

  • Mental Health Counselor
  • Marion, NC
  • NPI 1982276176

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1104452333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246A S MAIN ST",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287524551",
            "telephone_number": "828-237-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246A S MAIN ST",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287524551",
            "telephone_number": "252-559-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "PATRICK",
        "middle_name": "TRAVIS",
        "credential": "MA, LCMHC, LCAS, CSI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-19",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "25275",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A14792",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "14792",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wise Minds Counseling PLLC
• Amber Shea Wise, CADC-I
• Cristen Delaney Wisor, LCSW
• WNC People Helping People, LLC
• Ashlyn Wolfe, M.S., CCC-SLP
• Bailey Woody
• Alexandra Loven Yancey, LCMHC
• Miranda Gail Harmon Yerry
• Young Men Christian Association of Western North Carolina
• Your H.O.M.E., Inc

• Mental Health Counselor in Marion, NC
• Providers in Marion, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.