Individual provider Active NPI

Ricky A Speller Jr.

  • Counselor
  • Winston Salem, NC
National Provider Identifier
1568055549
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
AL6322 Issued in NC
Practice address
4680 Brownsboro Rd RM A2
Winston Salem, NC 27106-3428
Phone
(814) 218-2598
NPI assigned
Feb 19, 2021
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X AL6322 NC Primary

Addresses

Primary practice location

4680 Brownsboro Rd RM A2
Winston Salem, NC 27106-3428

Mailing address

1712 Yarborough Dr
Greensboro, NC 27405-2748
Phone (919) 612-3481

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
AL6322NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Counseling Services Counselor CurrentSince Feb 21, 2021 Accepting new patients

Locations

4680 Brownsboro Rd
Rm A2
Winston Salem, NC 27106
Phone (336) 261-6440

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1568055549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 YARBOROUGH DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274052748",
            "telephone_number": "919-612-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 BROWNSBORO RD RM A2",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063428",
            "telephone_number": "814-218-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLER",
        "first_name": "RICKY",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-19",
        "last_updated": "2026-09-29",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "AL6322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.