Active NPI
Frederick R Saravia, LPA
- Mental Health Counselor
- Wilmington, NC
National Provider Identifier
1295868339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1770
- Practice address
- 2595 S 17TH St
Wilmington, NC 28401-7748 - Phone
- (910) 799-2283
- Fax
- (910) 791-9227
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1770 | NC | Primary |
Addresses
Primary practice location
2595 S 17TH St
Wilmington, NC 28401-7748
Mailing address
1907 S 17TH St
Suite 1
Wilmington, NC 28401-6626
Phone (910) 343-8424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201516C | Other | NC | MEDICARE IND |
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 |
|---|---|---|---|
| 1770 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197331200000",
"number": "1295868339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 S 17TH ST",
"address_2": "SUITE 1",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284016626",
"telephone_number": "910-343-8424",
"fax_number": "910-343-6989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2595 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017748",
"telephone_number": "910-799-2283",
"fax_number": "910-791-9227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARAVIA",
"first_name": "FREDERICK",
"middle_name": "R",
"credential": "LPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2007-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "1770",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE IND",
"identifier": "201516C",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.