Individual provider Active NPI

Cynthia Cabaniss

  • Professional Counselor
  • Mount Airy, NC
National Provider Identifier
1396774360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1041 Issued in NC
Practice address
351 Riverside Dr
Mount Airy, NC 27030-3850
Phone
(336) 783-6919
Fax
(336) 783-6923
NPI assigned
Jul 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1041 NC Primary

Addresses

Primary practice location

351 Riverside Dr
Mount Airy, NC 27030-3850

Mailing address

217 W 2ND Ave
Lexington, NC 27292-3005
Phone (336) 783-6919

Other identifiers 1

IdentifierTypeStateIssuer
6102322MedicaidNC

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
I20240205000220 NC Practitioner - Mental Health Counselor 1951744218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1041NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of the Piedmont, Inc. Professional CurrentSince Jan 4, 2024 Accepting new patients
Family Service of the Piedmont, Inc Current Accepting new patients

Locations

315 E Washington St
Greensboro, NC 27401
Phone (336) 387-6161

1401 Long St
High Point, NC 27262
Phone (336) 387-6161

902 Bonner Dr
Jamestown, NC 27282
Phone (336) 387-6161

Organizations & group practices 2

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396774360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W 2ND AVE",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272923005",
            "telephone_number": "336-783-6919",
            "fax_number": "336-783-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 RIVERSIDE DR",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270303850",
            "telephone_number": "336-783-6919",
            "fax_number": "336-783-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABANISS",
        "first_name": "CYNTHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "1041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102322",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.