Tysha Deve Ushry, LPCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A11560 Issued in NC

Practice address

105 Dudley CT
Bayboro, NC 28515-9459

Phone

(910) 333-2789

Fax

(252) 633-1548

NPI assigned

Apr 15, 2015

Last updated

Apr 15, 2015By the provider in NPPES

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Second Chance Behavioral HealthGroup PAC ID 2961836408, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Second Chance Behavioral Health

  • Mental Health Counselor
  • New Bern, NC
  • NPI 1205341112
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1306232475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 DUDLEY CT",
            "city": "BAYBORO",
            "state": "NC",
            "postal_code": "285159459",
            "telephone_number": "910-333-2789",
            "fax_number": "252-633-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 DUDLEY CT",
            "city": "BAYBORO",
            "state": "NC",
            "postal_code": "285159459",
            "telephone_number": "910-333-2789",
            "fax_number": "252-633-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USHRY",
        "first_name": "TYSHA",
        "middle_name": "DEVE",
        "credential": "LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A11560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila L Stansberry, MSW, LCSW
• Linda Ann Straub, NP
• The Legacy Group Foundation, Inc
• Ren A Thorne, LCSW
• Trinity Adult and Senior Services LLC

• Mental Health Counselor in Bayboro, NC
• Providers in Bayboro, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.