Decassi Foundation

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DECASSI FOUNDATION

Practice address

114 New Edition CT
Cary, NC 27511-4449

Phone

(919) 633-9403

Fax

(919) 650-1420

NPI assigned

Sep 27, 2019

Last updated

Sep 27, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Delva DouglasNPI 1902275324

Title

Owner

Phone

(919) 633-9403

Specialties & licenses 7

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Delva Douglas, L.C.S.W.

  • Clinical Social Worker
  • Cary, NC
  • NPI 1902275324
  NPD Authorized official
• Shannon Brenee Judd, LCMHC

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1043891039

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1487205647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 NEW EDITION CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114449",
            "telephone_number": "919-633-9403",
            "fax_number": "919-650-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 NEW EDITION CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114449",
            "telephone_number": "919-633-9403",
            "fax_number": "919-650-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECASSI FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "DELVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-633-9403"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lena Deas
• Eleanor Virginia Deberry
• Angelia Debono
• Denise Veronica Freeman Decandia, BCBA
• Scott Ethan Decarlo, DPT
• Alyssa Leigh-Ann Decker
• Kristopher Wyatt Decker, PA-C
• Joshua Deena, LCSW
• Edward Deering, NURSE PRACTITIONER
• Christopher Brian Deery, MD

• Mental Health Counselor in Cary, NC
• Providers in Cary, 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 Sep 27, 2019; 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.