Fernandus Vinson, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

705 Cumberland St
Fayetteville, NC 28301-7020

Phone

(910) 797-9335

Fax

(910) 485-1543

NPI assigned

Mar 22, 2020

Last updated

Aug 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Restorative Therapeutic Counseling

  • Mental Health Counselor
  • Fayetteville, NC
  • NPI 1447966650
  NPD Authorized official
• Haire Enterprises, LLC

  dba Community Re-Entry Program

  • Community/Behavioral Health Agency
  • Fayetteville, NC
  • NPI 1376732370
  NPD (past)

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1467088401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 CUMBERLAND ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283017020",
            "telephone_number": "910-797-9335",
            "fax_number": "910-485-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 CUMBERLAND ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283017020",
            "telephone_number": "910-797-9335",
            "fax_number": "910-485-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "FERNANDUS",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-22",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15490",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Fayetteville",
            "affiliation": "N",
            "address_1": "705 Cumberland St",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283017020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Fayetteville",
            "affiliation": "N",
            "address_1": "705 Cumberland St",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283017020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "CRV",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "705 Cumberland St",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283017020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Village Pharmacy LLC (Village Pharmacy)
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• Latonya R. Villanueva, PHARMD
• Maria Joanna Villena, M.D.
• Deja Vinson
• Vikas M Virkud, MD,FACC
• Virtuous Medical
• Vision International PA (Carolina Vision Center)
• Visions Residential Healthcare Services
• Visions Residential Healthcare Services

• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, 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 Aug 26, 2021; 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.