Individual provider Active NPI

Tiarra Charelle Morris, LCMHC, LCAS

  • Professional Counselor
  • Greensboro, NC
National Provider Identifier
1558743542
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11705 Issued in NC
Practice address
3209 Allerton Circle
E
Greensboro, NC 27409
Phone
(743) 201-5834
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11705 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 21911 NC

Addresses

Primary practice location

3209 Allerton Circle
E
Greensboro, NC 27409

Mailing address

PO Box 2420
Kernersville, NC 27285-2420
Phone (743) 201-5834

Other practice location 1

650 Highland Ave
Winston Salem, NC 27101-4304
Phone (336) 607-8523

Other practice location 2

1922 S Martin Luther King Jr Dr
Winston Salem, NC 27107-1361
Phone (336) 908-9936

Other practice location 3

725 Highland Ave
Winston Salem, NC 27101-4180
Phone (336) 607-8523

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
I20231222000660 NC Practitioner - Mental Health Counselor 2466802079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21911NCMDAddiction (Substance Use Disorder) Counselor
11705NCMDGeriatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1558743542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2420",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272852420",
            "telephone_number": "743-201-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 ALLERTON CIRCLE",
            "address_2": "E",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27409",
            "telephone_number": "743-201-5834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271014304",
            "country_code": "US",
            "telephone_number": "336-607-8523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1922 S Martin Luther King Jr Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271071361",
            "country_code": "US",
            "telephone_number": "336-908-9936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271014180",
            "country_code": "US",
            "telephone_number": "336-607-8523",
            "fax_number": "336-607-8647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "TIARRA",
        "middle_name": "CHARELLE",
        "credential": "LCMHC, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2023-06-21",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "11705",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "21911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.