Individual provider Active NPI

Dana Lo Don Rouse, LCSWA, LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Jacksonville, NC
National Provider Identifier
1538873229
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCAS-28368 Issued in NC
Practice address
201 New Bridge St Ste 105
Jacksonville, NC 28540-4736
Phone
(252) 268-5105
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P017852 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-28368 NC Primary

Addresses

Primary practice location

201 New Bridge St Ste 105
Jacksonville, NC 28540-4736

Mailing address

4132 Hwy 123 N
Snow Hill, NC 28580-7558
Phone (252) 268-5105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240417000451 NC Practitioner - Clinical Social Worker 9032558531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-28368NCMDAddiction (Substance Use Disorder) Counselor
P017852NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1538873229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 HWY 123 N",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285807558",
            "telephone_number": "252-268-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NEW BRIDGE ST STE 105",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404736",
            "telephone_number": "252-268-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "DANA",
        "middle_name": "LO DON",
        "name_prefix": "Ms.",
        "credential": "LCSWA, LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P017852",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-28368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.