Individual provider Active NPI

Tanya McKoy-Sutton, LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Raleigh, NC
National Provider Identifier
1265823611
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
21154 Issued in NC
Practice address
2000 Yonkers Rd
Raleigh, NC 27604-2258
Phone
(919) 931-2704
NPI assigned
Feb 6, 2015
Last updated
Aug 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 21154 NC Primary

Addresses

Primary practice location

2000 Yonkers Rd
Raleigh, NC 27604-2258

Mailing address

1113 Penncross Dr
Raleigh, NC 27610-6065
Phone (919) 931-2704

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
21154NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1265823611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 PENNCROSS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276106065",
            "telephone_number": "919-931-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 YONKERS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042258",
            "telephone_number": "919-931-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOY-SUTTON",
        "first_name": "TANYA",
        "credential": "LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-06",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "21154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.