Individual provider Active NPI

Kierra Lasha Staton, LMFT

  • Marriage & Family Therapist
  • Durham, NC
National Provider Identifier
1568951499
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2124 Issued in NC
Practice address
5826 Fayetteville Rd Ste 211
Durham, NC 27713-8684
Phone
(617) 379-0496
NPI assigned
May 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2124 NC Primary

Addresses

Primary practice location

5826 Fayetteville Rd Ste 211
Durham, NC 27713-8684

Mailing address

5826 Fayetteville Rd Ste 211
Durham, NC 27713-8684

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
I20240415003583 NC Practitioner - Marriage and Family Therapist 2264871821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - North Carolina PCGroup PAC ID 8527471200, 109 clinicians

Practice addresses (Care Compare)

5826 Fayetteville Rd
Suite 211
Durham, NC 27713-8684
Phone (919) 629-3854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2124NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - North Carolina PC CurrentSince Feb 27, 2024 Accepting new patients

Locations

119 SW Maynard Rd
Cary, NC 27511
Phone (919) 415-1112

5826 Fayetteville Rd
Ste 211
Durham, NC 27713
Phone (855) 675-4144

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1568951499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5826 FAYETTEVILLE RD STE 211",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5826 FAYETTEVILLE RD STE 211",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138684",
            "telephone_number": "617-379-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "KIERRA",
        "middle_name": "LASHA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "2124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.