Active NPI
Diana Wilma Avila, LCAS
- Addiction (Substance Use Disorder) Counselor
- Fayetteville, NC
National Provider Identifier
1124443163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCAS-20054
- Practice address
- 1724 Roxie Ave
Fayetteville, NC 28304-1623 - Phone
- (910) 615-3333
- NPI assigned
- Feb 27, 2014
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-20054 | NC | Primary |
Addresses
Primary practice location
1724 Roxie Ave
Fayetteville, NC 28304-1623
Mailing address
1724 Roxie Ave
Fayetteville, NC 28304-1623
Phone (910) 615-3333
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 |
|---|---|---|---|
| LCAS-20054 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393459200000",
"number": "1124443163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1724 ROXIE AVE",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283041623",
"telephone_number": "910-615-3333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1724 ROXIE AVE",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283041623",
"telephone_number": "910-615-3333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "DIANA",
"middle_name": "WILMA",
"credential": "LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-27",
"last_updated": "2014-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-20054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.