Doressia McKethan

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1952 Simon St
Fayetteville, NC 28312-5380

Phone

(910) 797-7490

NPI assigned

May 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Opendors,LLC.

  • Mental Illness Community Based Residential Treatment Facility
  • Monroe, NC
  • NPI 1497410526
  NPD Authorized official

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1235518457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 SIMON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283125380",
            "telephone_number": "910-797-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 SIMON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283125380",
            "telephone_number": "910-797-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKETHAN",
        "first_name": "DORESSIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle McKenzie
• Donnesha McKenzie, LCSWA
• Savannah McKenzie
• Te'Cara McKenzie
• Darius McKethan
• Mikenzie McKimmie, LCSWA
• Elizabeth A McKinley, MS, CCC-SLP
• Kyle Patrick McKinley, DO
• Carolyn Elise Pockat McKinney, DPT
• Jessica McKinney

• Addiction (Substance Use Disorder) Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.

Verify at the official NPI Registry.