Organization Active NPI

Families 1St Counseling, PLLC

  • Professional Counselor
  • Fayetteville, NC
National Provider Identifier
1275769200
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7255 Issued in NC
Legal business name
FAMILIES 1ST COUNSELING, PLLC
Practice address
346 Wagoner Dr
Suite 106
Fayetteville, NC 28303-4680
Phone
(910) 864-0179
Fax
(910) 864-3162
NPI assigned
Jun 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Authorized official

Name
Mrs. Tomeka Davis Shaw, LPC, NCCNPI 1629214846
Title
Executive Director/Owner
Phone
(910) 797-5661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 7255 NC
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 7255 NC Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 1596 NC
Community/Behavioral Health Agency 251S00000X 7255 NC
Early Intervention Provider Agency 252Y00000X 7255 NC

Addresses

Primary practice location

346 Wagoner Dr
Suite 106
Fayetteville, NC 28303-4680

Mailing address

346 Wagoner Dr
Suite 106
Fayetteville, NC 28303-4680
Phone (910) 864-0179

Other identifiers 5

IdentifierTypeStateIssuer
437554OtherNCTRICARE
6104094MedicaidNC
151XROtherNCBCBS
13857OtherNCBCBS
6107612MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1275769200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 WAGONER DR",
            "address_2": "SUITE 106",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034680",
            "telephone_number": "910-864-0179",
            "fax_number": "910-864-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 WAGONER DR",
            "address_2": "SUITE 106",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034680",
            "telephone_number": "910-864-0179",
            "fax_number": "910-864-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIES 1ST COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "TOMEKA",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/OWNER",
        "authorized_official_telephone_number": "910-797-5661",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7255",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7255",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1596",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "7255",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": "7255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "437554",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104094",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "151XR",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13857",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107612",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; 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.