Individual provider Active NPI

Rebecca Burruss, MS, LCAS, LCMHC

  • Mental Health Counselor
  • High Point, NC
National Provider Identifier
1629471693
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
16704 Issued in NC
Practice address
1401 Long St
High Point, NC 27262-2541
Phone
(336) 889-6161
NPI assigned
Oct 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2348-226 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 15862-132 WI
Mental Health Counselor 101YM0800X 16704 NC Primary

Addresses

Primary practice location

1401 Long St
High Point, NC 27262-2541

Mailing address

1401 Long St
High Point, NC 27262-2541
Phone (336) 889-6161

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
I20240220000366 NC Practitioner - Mental Health Counselor 4789028689 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2348-226WIMDCounselor
15862-132WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of the Piedmont, Inc. Addiction (Substance Use Disorder) CurrentSince Jan 4, 2024 Accepting new patients
Family Service of the Piedmont, Inc Addiction (Substance Use Disorder) CurrentSince Jan 4, 2024 Accepting new patients

Locations

315 E Washington St
Greensboro, NC 27401
Phone (336) 387-6161

1401 Long St
High Point, NC 27262
Phone (336) 387-6161

902 Bonner Dr
Jamestown, NC 27282
Phone (336) 387-6161

Organizations & group practices 2

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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1629471693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 LONG ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272622541",
            "telephone_number": "336-889-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 LONG ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272622541",
            "telephone_number": "336-889-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUSS",
        "first_name": "REBECCA",
        "credential": "MS, LCAS, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "2348-226",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15862-132",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "16704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.