Active NPI
Nancy Ausbon Willis, LCAS, CCS
- Addiction (Substance Use Disorder) Counselor
- Charlotte, NC
National Provider Identifier
1235331471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 584
- Practice address
- 100 Billingsley Rd
Charlotte, NC 28211-1002 - Phone
- (704) 376-7447
- NPI assigned
- Jun 1, 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 584 | NC | Primary |
Addresses
Primary practice location
100 Billingsley Rd
Charlotte, NC 28211-1002
Mailing address
3015 Chinaberry Court
Matthews, NC 28104-4314
Phone (704) 882-3491
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6110517 | Medicaid | NC |
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 |
|---|---|---|---|
| 584 | 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": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1235331471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3015 CHINABERRY COURT",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281044314",
"telephone_number": "704-882-3491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BILLINGSLEY RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111002",
"telephone_number": "704-376-7447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "NANCY",
"middle_name": "AUSBON",
"name_prefix": "Ms.",
"credential": "LCAS, CCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "584",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6110517",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.