Individual provider Active NPI

Daja Kiara Prather, LCMHCA

  • Mental Health Counselor
  • Harrisburg, NC
National Provider Identifier
1619725413
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A19817 Issued in NC
Practice address
4560 State Highway 49
Harrisburg, NC 28075
Phone
(704) 375-5354
NPI assigned
May 8, 2024
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 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 A19817 NC Primary

Addresses

Primary practice location

4560 State Highway 49
Harrisburg, NC 28075

Mailing address

7209 Somerford Rd
Charlotte, NC 28215-6104
Phone (980) 208-2722

Other names 1

  • Daija Kiara Prather Other name

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
I20260519003639 NC Practitioner - Mental Health Counselor 4587133558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2129 E 7TH St
Charlotte, NC 28204-3337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A19817NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sanctuary Counseling Group Mental Health Past Accepting new patients

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": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1619725413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 SOMERFORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282156104",
            "telephone_number": "980-208-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 STATE HIGHWAY 49",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "28075",
            "telephone_number": "704-375-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATHER",
        "first_name": "DAJA",
        "middle_name": "KIARA",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A19817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAIJA",
            "last_name": "PRATHER",
            "middle_name": "KIARA",
            "credential": "LCMHCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrisburg, NC

Sources for this page

Verify at the official NPI Registry.