Active NPI
Ginnovia Rena Dumas
- Mental Health Counselor
- Jacksonville, NC
National Provider Identifier
1104544543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 15201
- Practice address
- 302 Chisholm TRL
Jacksonville, NC 28546-9289 - Phone
- (910) 459-5514
- NPI assigned
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 15201 | NC | Primary |
Addresses
Primary practice location
302 Chisholm TRL
Jacksonville, NC 28546-9289
Mailing address
302 Chisholm TRL
Jacksonville, NC 28546-9289
Phone (910) 219-0967
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 |
|---|---|---|---|
| 15201 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1104544543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 CHISHOLM TRL",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285469289",
"telephone_number": "910-219-0967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 CHISHOLM TRL",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285469289",
"telephone_number": "910-459-5514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMAS",
"first_name": "GINNOVIA",
"middle_name": "RENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-22",
"last_updated": "2022-08-24",
"certification_date": "2022-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "15201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.