Individual provider Active NPI

Michael W Whitley, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Lillington, NC
National Provider Identifier
1437364783
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
23 Issued in NC
Practice address
133 W Cornelius-Harnett Blvd
Suite B
Lillington, NC 27546-7854
Phone
(910) 814-0394
Fax
(910) 814-1426
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 23 NC Primary

Addresses

Primary practice location

133 W Cornelius-Harnett Blvd
Suite B
Lillington, NC 27546-7854

Mailing address

108 N Orange Ave
Dunn, NC 28334-3826
Phone (910) 891-7062

Other identifiers 2

IdentifierTypeStateIssuer
23OtherNCLCAS
6111840MedicaidNC

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

State licenses

LicenseStateTypeSpecialty
23NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1437364783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N ORANGE AVE",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283343826",
            "telephone_number": "910-891-7062",
            "fax_number": "910-892-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W CORNELIUS-HARNETT BLVD",
            "address_2": "SUITE B",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275467854",
            "telephone_number": "910-814-0394",
            "fax_number": "910-814-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LCAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCAS",
            "identifier": "23",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111840",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.