Organization Active NPI

Innerfoundations, Inc

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1558406843
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
INNERFOUNDATIONS, INC
Practice address
316 W Millbrook Rd Ste 109
Raleigh, NC 27609-4482
Phone
(919) 847-6514
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. La Vera Brown, LPC
Title
President
Phone
(919) 345-4664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

316 W Millbrook Rd Ste 109
Raleigh, NC 27609-4482

Mailing address

316 W Millbrook Rd Ste 109
Raleigh, NC 27609-4482

Other identifiers 1

IdentifierTypeStateIssuer
6005953MedicaidNC

National Provider Directory

National Provider Directory

Locations

316 W Millbrook Rd
Ste 109
Raleigh, NC 27609
Phone (919) 633-7775

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558406843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W MILLBROOK RD STE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W MILLBROOK RD STE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094482",
            "telephone_number": "919-847-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERFOUNDATIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LA VERA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-345-4664",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005953",
            "state": "NC"
        }
    ],
    "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 Aug 22, 2020; 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.