Rene Whitehead, MS, LCAS-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

29437 Issued in NC

Practice address

355 Beckwith Ave
Clayton, NC 27527-4258

Phone

(919) 538-8920

NPI assigned

Nov 10, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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.

• Life Changez, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1184226409
  NPD Authorized official

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1255105185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BECKWITH AVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275274258",
            "telephone_number": "919-538-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BECKWITH AVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275274258",
            "telephone_number": "919-538-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "RENE",
        "credential": "MS, LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "29437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Whitaker, COTA/L
• Katena White
• Michael R. White, DPT
• Tekia Nicole White
• Whitney Norton White
• Stacey Whitehead
• Wendy Whitfield
• Carolyn Barnnette Whitley
• Marika Patrycja Widmann, DNP
• Ashante Wiggins

• Addiction (Substance Use Disorder) Counselor in Clayton, NC
• Providers in Clayton, 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 Nov 10, 2023; 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.