Individual provider Active NPI

Lillie Dorishree Tarver, PLCSW

  • Mental Health Counselor
  • Fayetteville, NC
National Provider Identifier
1225387269
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P006877 Issued in NC
Practice address
2800 Breezewood Ave
Suite 100
Fayetteville, NC 28303-5286
Phone
(910) 483-8213
Fax
(910) 483-8214
NPI assigned
Sep 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P006877 NC Primary

Addresses

Primary practice location

2800 Breezewood Ave
Suite 100
Fayetteville, NC 28303-5286

Mailing address

3210 Fairhill Dr
Raleigh, NC 27612-3215
Phone (919) 256-0824

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

LicenseStateTypeSpecialty
P006877NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1225387269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 FAIRHILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123215",
            "telephone_number": "919-256-0824",
            "fax_number": "919-256-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BREEZEWOOD AVE",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035286",
            "telephone_number": "910-483-8213",
            "fax_number": "910-483-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARVER",
        "first_name": "LILLIE",
        "middle_name": "DORISHREE",
        "credential": "PLCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P006877",
            "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 Sep 6, 2012; 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.