Organization Active NPI

Blue Rose Counseling, PLLC

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1356005706
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BLUE ROSE COUNSELING, PLLC
Practice address
1415 W NC Highway 54 Ste 111
Durham, NC 27707-5597
Phone
(919) 612-1213
Fax
(919) 287-2245
NPI assigned
Oct 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Ms. Barbara Ray Lovelady, LCSW, LCAS, CSINPI 1083080592
Title
Executive Director
Phone
(919) 612-1213

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1415 W NC Highway 54 Ste 111
Durham, NC 27707-5597

Mailing address

3710 Shannon Rd Unit 52054
Durham, NC 27717-0750
Phone (919) 612-1213

Other identifiers 1

IdentifierTypeStateIssuer
1083080592OtherNCNPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220331002129 NC Part B Supplier - Clinic/Group Practice 8224424197 Receives reassigned benefits from 1 practitioner
Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Locations

1415 W NC Highway 54
Ste 111
Durham, NC 27707
Phone (919) 294-8981

3710 Shannon Rd
Unit 52054
Durham, NC 27717

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1356005706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 SHANNON RD UNIT 52054",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277170750",
            "telephone_number": "919-612-1213",
            "fax_number": "919-287-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 W NC HIGHWAY 54 STE 111",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075597",
            "telephone_number": "919-612-1213",
            "fax_number": "919-287-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ROSE COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-22",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "LOVELADY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-612-1213",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, LCAS, CSI"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1083080592",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.