Active NPI
Judith Liseth Ayala, LPC, LCAS
- Mental Health Counselor
- Gastonia, NC
National Provider Identifier
1255715801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A11438
- Practice address
- 1562 Union Rd Ste B
Gastonia, NC 28054-2210 - Phone
- (704) 201-1370
- NPI assigned
- Jul 14, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-20973 | NC | |
| Mental Health Counselor | 101YM0800X | A11438 | NC | Primary |
Addresses
Primary practice location
1562 Union Rd Ste B
Gastonia, NC 28054-2210
Mailing address
1552 Union Rd
Suite E
Gastonia, NC 28054-5523
Phone (704) 833-0154
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 |
|---|---|---|---|
| LCAS-20973 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A11438 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deepest Needs Christian Counseling, PLLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Children's Advocacy Network, LLC | Past | Accepting new patients |
Locations
1562 Union Rd
Ste B
Gastonia, NC 28054
Phone (704) 201-1370
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Gastonia, NC
- NPI 1346994381
Addiction (Substance Use Disorder)
-
dba Deepest Need Counseling
- Community/Behavioral Health Agency
- Gastonia, NC
- NPI 1609230770
-
- Community/Behavioral Health Agency
- Gastonia, NC
- NPI 1154440931
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1255715801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1552 UNION RD",
"address_2": "SUITE E",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545523",
"telephone_number": "704-833-0154",
"fax_number": "704-833-7076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1562 UNION RD STE B",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542210",
"telephone_number": "704-201-1370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYALA",
"first_name": "JUDITH",
"middle_name": "LISETH",
"credential": "LPC, LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-14",
"last_updated": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-20973",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A11438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.