Keni Sanita Church-Hines, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

15368 Issued in NC

Practice address

131 Southerland St
Durham, NC 27703-2315

Phone

(984) 222-9272

NPI assigned

Nov 26, 2019

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitae Health Medical North Carolina PLLCGroup PAC ID 7719317932, 41 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.

• Telos Health Systems NC PLLC

  • Internal Medicine Physician
  • Mooresville, NC
  • NPI 1265064414
  Medicare reassignment Care Compare group NPD
• An Out of the Box Experience, P.C.

  • Mental Health Counselor
  • Durham, NC
  • NPI 1790302487
  NPD Authorized official
• Church Boi Empowerment Company

  • Mental Health Counselor
  • Durham, NC
  • NPI 1649064957
  NPD Authorized official
• KBX Pathways to Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Raleigh, NC
  • NPI 1174466999
  NPD Authorized official
• Chestnut Knoll Physicians Group PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1780477729

  NC

  Medicare reassignment

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1316583214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 SOUTHERLAND ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032315",
            "telephone_number": "984-222-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 SOUTHERLAND ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032315",
            "telephone_number": "984-222-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH-HINES",
        "first_name": "KENI",
        "middle_name": "SANITA",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Byonghee Chung, MD
• John Chung
• Kayla K Chung, MSPT
• Linda Christine Chupkowski, LCSW
• Church Boi Empowerment Company
• Valencia Church-Williams, ED.D, LBA, QBA. CAS
• Alison M Church, MD
• Vanessa Michaela Church
• William Church, DDS
• Bryce Matthew Churilla, MD

• Mental Health Counselor in Durham, NC
• Providers in Durham, 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 Jul 7, 2021; 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.