Individual provider Active NPI

Ardis Gregory, LPC

  • Mental Health Counselor
  • Roanoke, VA
National Provider Identifier
1619346897
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701006253 Issued in VA
Practice address
422 Elm Ave SW
Roanoke, VA 24016-3920
Phone
(540) 344-4600
NPI assigned
Sep 17, 2015
Last updated
Sep 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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 0701006253 VA Primary

Addresses

Primary practice location

422 Elm Ave SW
Roanoke, VA 24016-3920

Mailing address

422 Elm Ave SW
Roanoke, VA 24016-3920
Phone (540) 344-4600

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
0701006253VAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1619346897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 ELM AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240163920",
            "telephone_number": "540-344-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 ELM AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240163920",
            "telephone_number": "540-344-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "ARDIS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701006253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.