Inez Marie Serventi, PHD, MSW, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C004887 Issued in NC

Practice address

106 Oakley Ave
Suite 300
Pineville, NC 28134-8619

Phone

(704) 806-3200

Fax

(704) 889-5649

NPI assigned

Aug 11, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1316959380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 OAKLEY AVE",
            "address_2": "SUITE 300",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281348619",
            "telephone_number": "704-806-3200",
            "fax_number": "704-889-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 OAKLEY AVE",
            "address_2": "SUITE 300",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281348619",
            "telephone_number": "704-806-3200",
            "fax_number": "704-889-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVENTI",
        "first_name": "INEZ",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD, MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C004887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PROVIDER NUMBER",
            "identifier": "184757",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC PROVIDER NUMBER",
            "identifier": "140GP",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Pineville, NC
• Providers in Pineville, 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 12, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.