Individual provider Active NPI

Autumn Devitt, LMFT, LCAS

  • Marriage & Family Therapist
  • Winston Salem, NC
National Provider Identifier
1306307806
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
12139A Issued in NC
Practice address
1022 W 1St St
Winston Salem, NC 27101-3642
Phone
(336) 914-3038
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12139A NC Primary

Addresses

Primary practice location

1022 W 1St St
Winston Salem, NC 27101-3642

Mailing address

2417 Hoyt St
Winston Salem, NC 27103-4313
Phone (828) 768-2896

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
12139ANCMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1306307806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 HOYT ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034313",
            "telephone_number": "828-768-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 W 1ST ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013642",
            "telephone_number": "336-914-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVITT",
        "first_name": "AUTUMN",
        "credential": "LMFT, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12139A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.