Keith Daniel Hairston, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A17714 Issued in NC

Practice address

3240 NC Highway 14
Reidsville, NC 27320-8718

Phone

(276) 226-5697

NPI assigned

Feb 24, 2023

Last updated

Feb 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1437858826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 NC HIGHWAY 14",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208718",
            "telephone_number": "276-226-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 NC HIGHWAY 14",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208718",
            "telephone_number": "276-226-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIRSTON",
        "first_name": "KEITH",
        "middle_name": "DANIEL",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Reidsville, NC
• Providers in Reidsville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.