Individual provider Active NPI

Larry Fitzpatrick, LPCA, LCASA

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1487142089
Registry record updated Apr 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A13885 Issued in NC
Practice address
2321 Crabtree Blvd Ste 250
Raleigh, NC 27604-2263
Phone
(919) 848-9108
NPI assigned
Apr 29, 2018
Last updated
Apr 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-20196 NC
Mental Health Counselor 101YM0800X A13885 NC Primary

Addresses

Primary practice location

2321 Crabtree Blvd Ste 250
Raleigh, NC 27604-2263

Mailing address

1124 Dexter Ridge Dr
Holly Springs, NC 27540-7663

Other practice location 1

309 W Millbrook Rd Ste 161
Raleigh, NC 27609-4261
Phone (919) 559-8690

Other practice location 2

1124 Dexter Ridge Dr
Holly Springs, NC 27540-7663
Phone (919) 285-6954

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
LCAS-20196NCMDAddiction (Substance Use Disorder) Counselor
A13885NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524960000000",
    "number": "1487142089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 DEXTER RIDGE DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275407663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 CRABTREE BLVD STE 250",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042263",
            "telephone_number": "919-848-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 W Millbrook Rd Ste 161",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276094261",
            "country_code": "US",
            "telephone_number": "919-559-8690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1124 Dexter Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Holly Springs",
            "state": "NC",
            "postal_code": "275407663",
            "country_code": "US",
            "telephone_number": "919-285-6954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "LARRY",
        "credential": "LPCA, LCASA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-29",
        "last_updated": "2018-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-20196",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A13885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2018; 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.