Active NPI
Rea Lyn White
- Professional Counselor
- Hiddenite, NC
National Provider Identifier
1306551304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A18440
- Practice address
- 105 Hiddenite Church Rd
Hiddenite, NC 28636-8168 - Phone
- (704) 880-1202
- Fax
- (828) 471-3318
- NPI assigned
- Jan 16, 2023
- Last updated
- Jan 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A18440 | NC | Primary |
Addresses
Primary practice location
105 Hiddenite Church Rd
Hiddenite, NC 28636-8168
Mailing address
808 Birchcrest Dr
Statesville, NC 28677-3188
Phone (704) 880-1202
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 |
|---|---|---|---|
| A18440 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1306551304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 BIRCHCREST DR",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286773188",
"telephone_number": "704-880-1202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 HIDDENITE CHURCH RD",
"city": "HIDDENITE",
"state": "NC",
"postal_code": "286368168",
"telephone_number": "704-880-1202",
"fax_number": "828-471-3318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "REA",
"middle_name": "LYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A18440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hiddenite, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.