Active NPI
Beverly Linn Pacos, MED, NCC, LPC
- Professional Counselor
- Raleigh, NC
National Provider Identifier
1184767691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6765
- Practice address
- 4000 Blue Ridge Rd
Ste. 200
Raleigh, NC 27612-4650 - Phone
- (919) 782-4981
- Fax
- (919) 782-2474
- NPI assigned
- Feb 14, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6765 | NC | Primary |
Addresses
Primary practice location
4000 Blue Ridge Rd
Ste. 200
Raleigh, NC 27612-4650
Mailing address
5004 Hanna LN
Fuquay Varina, NC 27526-9093
Phone (919) 524-0015
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6765 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freshwinds, Inc | Professional | Past | Accepting new patients |
| Youth Development Corporation of America | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Crabtree Creek Clinic
- Community/Behavioral Health Agency
- Raleigh, NC
- NPI 1952518110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1184767691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5004 HANNA LN",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275269093",
"telephone_number": "919-524-0015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 BLUE RIDGE RD",
"address_2": "STE. 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276124650",
"telephone_number": "919-782-4981",
"fax_number": "919-782-2474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACOS",
"first_name": "BEVERLY",
"middle_name": "LINN",
"credential": "MED, NCC, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "6765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.