Active NPI
Kylie Phares Dotson-Blake, PHD, LPC, NCC
- Professional Counselor
- Greenville, NC
National Provider Identifier
1336375062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4986
- Practice address
- East Fifth Street 223a Ragsdale
East Carolina University/Coad Dept
Greenville, NC 27858-4353 - Phone
- (252) 328-5277
- NPI assigned
- Jun 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4986 | NC | Primary |
| School Counselor | 101YS0200X | NC |
Addresses
Primary practice location
East Fifth Street 223a Ragsdale
East Carolina University/Coad Dept
Greenville, NC 27858-4353
Mailing address
East Fifth Street 223a Ragsdale
East Carolina University/Coad Dept
Greenville, NC 27858-4353
Phone (252) 328-5277
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4986 | NC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244505600000",
"number": "1336375062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "EAST FIFTH STREET 223A RAGSDALE",
"address_2": "EAST CAROLINA UNIVERSITY/COAD DEPT",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278584353",
"telephone_number": "252-328-5277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "EAST FIFTH STREET 223A RAGSDALE",
"address_2": "EAST CAROLINA UNIVERSITY/COAD DEPT",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278584353",
"telephone_number": "252-328-5277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTSON-BLAKE",
"first_name": "KYLIE",
"middle_name": "PHARES",
"name_prefix": "Dr.",
"credential": "PHD, LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-09",
"last_updated": "2009-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4986",
"primary": true
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "NC",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.