Active NPI
Erin Grace Van Vactor, NCC, LCMHC, M.S.
- Mental Health Counselor
- Clayton, NC
National Provider Identifier
1386137768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14024
- Practice address
- 205 S Boling Street
Clayton, NC 27520 - Phone
- (919) 297-8656
- NPI assigned
- Jun 11, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14024 | NC | Primary |
Addresses
Primary practice location
205 S Boling Street
Clayton, NC 27520
Mailing address
205 S Boling Street
Clayton, NC 27527
Phone (199) 297-8656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386137768 | Other | NC | NPI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.neuserivercounseling.com | Direct |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14024 | NC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuse River Counseling | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Professional Counselor
- Clayton, NC
- NPI 1407438351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1386137768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 S BOLING STREET",
"city": "CLAYTON",
"state": "NC",
"postal_code": "27527",
"telephone_number": "199-297-8656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S BOLING STREET",
"city": "CLAYTON",
"state": "NC",
"postal_code": "27520",
"telephone_number": "919-297-8656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN VACTOR",
"first_name": "ERIN",
"middle_name": "GRACE",
"credential": "NCC, LCMHC, M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-11",
"last_updated": "2024-04-18",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "14024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1386137768",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.neuserivercounseling.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "205 s boling street",
"city": "Clayton",
"state": "NC",
"country_code": "US",
"postal_code": "27520",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.