Individual provider Active NPI

Tonjia Kiara Armstrong, LCMHCA, NCC, MS

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1609402346
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A15616 Issued in NC
Practice address
206 Fair Oaks LN
Winston Salem, NC 27127-3178
Phone
(336) 745-7179
Fax
(336) 842-3055
NPI assigned
Mar 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A15616 NC Primary

Addresses

Primary practice location

206 Fair Oaks LN
Winston Salem, NC 27127-3178

Mailing address

206 Fair Oaks LN
Winston Salem, NC 27127-3178
Phone (336) 745-7179

Other practice location 1

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

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
I20231218003673 NC Practitioner - Mental Health Counselor 2769831650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

3205 Randall Pkwy
Suite 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
A15616NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina CurrentSince Aug 1, 2024 Accepting new patients
Lifesource of North Carolina CurrentSince Aug 1, 2024 Accepting new patients
Southerland Treatment and Rehab(Star) Counseling&Consulting SVCS, PLLC PastSince Mar 22, 2020 Accepting new patients

Locations

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

Organizations & group practices 3

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": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1609402346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 FAIR OAKS LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273178",
            "telephone_number": "336-745-7179",
            "fax_number": "336-842-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 FAIR OAKS LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273178",
            "telephone_number": "336-745-7179",
            "fax_number": "336-842-3055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "TONJIA",
        "middle_name": "KIARA",
        "name_prefix": "Mrs.",
        "credential": "LCMHCA, NCC, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.