Kami Latisha Dale, LCAS-A, LCMHC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A17389 Issued in NC

Practice address

933 Hidden Creek Dr Apt 204
Fayetteville, NC 28314-0354

Phone

(910) 580-6554

NPI assigned

Mar 8, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1154078319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 HIDDEN CREEK DR APT 204",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140354",
            "telephone_number": "910-580-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 HIDDEN CREEK DR APT 204",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140354",
            "telephone_number": "910-580-6554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "933 Hidden Creek Dr Apt 204",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283140354",
            "country_code": "US",
            "telephone_number": "910-580-6554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALE",
        "first_name": "KAMI",
        "middle_name": "LATISHA",
        "name_prefix": "Ms.",
        "credential": "LCAS-A, LCMHC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, 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 Mar 8, 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.

Verify at the official NPI Registry.