Active NPI
Timeka A Southerland, LPC
- Professional Counselor
- Winston Salem, NC
National Provider Identifier
1215163167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8201
- Practice address
- 206 Fair Oaks LN
Winston Salem, NC 27127-3178 - Phone
- (336) 745-7179
- NPI assigned
- Jun 5, 2009
- Last updated
- Aug 31, 2015
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8201 | NC | Primary |
Addresses
Primary practice location
206 Fair Oaks LN
Winston Salem, NC 27127-3178
Mailing address
2048 Lauren Woods Dr
Winston Salem, NC 27127-8917
Phone (336) 745-7179
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 |
|---|---|---|---|
| 8201 | NC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southerland Treatment and Rehab(Star) Counseling&Consulting SVCS, PLLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Winston Salem, NC
- NPI 1396215737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1215163167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2048 LAUREN WOODS DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271278917",
"telephone_number": "336-745-7179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 FAIR OAKS LN",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271273178",
"telephone_number": "336-745-7179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHERLAND",
"first_name": "TIMEKA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-05",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "8201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
- Candice Rae Sotriffer, M.A. ED.S LPC
- South Park Family Pharmacy LLC (South Park Family Pharmacy)
- John K Southard Jr., M.D.
- Monica Espinoza Southard, MA BCBA
- Southerland Treatment and Rehab(Star) Counseling&Consulting SVCS, PLLC
- Southern Assisted Living, LLC. (Brookdale Reynolda Road)
- Southern Home Care Services, Inc.
- Betsy W Southern, PA-C
- Molly R. Southern, P.T.
- Rebecca Bane Southern, MA/CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.