Individual provider Active NPI

Terri Ellerbe-Graves, LPCA

  • Professional Counselor
  • Davidson, NC
National Provider Identifier
1356748651
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A11187 Issued in NC
Practice address
505 Park Avenue
Apt 2
Davidson, NC 28036
Phone
(910) 331-3468
NPI assigned
Dec 2, 2014
Last updated
Dec 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A11187 NC Primary

Addresses

Primary practice location

505 Park Avenue
Apt 2
Davidson, NC 28036

Mailing address

505 Park Ave
Davidson, NC 28036-5513
Phone (910) 331-3468

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240215000408 NC Practitioner - Mental Health Counselor 4688018948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4822 Albemarle Rd
112B
Charlotte, NC 28205-6668
Phone (704) 532-5757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A11187NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
S.T.E.P's Developmental Academy, Inc. CurrentSince Feb 5, 2024 Accepting new patients

Locations

4822 Albemarle Rd
#112B
Charlotte, NC 28205
Phone (704) 532-5757

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1356748651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARK AVE",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280365513",
            "telephone_number": "910-331-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARK AVENUE",
            "address_2": "APT 2",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "28036",
            "telephone_number": "910-331-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERBE-GRAVES",
        "first_name": "TERRI",
        "credential": "LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A11187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

Verify at the official NPI Registry.