Individual provider Active NPI

Daniel Ernest Liles, LCMHC

  • Mental Health Counselor
  • Winterville, NC
National Provider Identifier
1629523188
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12446 Issued in NC
Practice address
108 W Fire Tower Rd
Suite D
Winterville, NC 28590-8371
Phone
(252) 830-3300
Fax
(252) 830-3322
NPI assigned
Aug 24, 2016
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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 12446 NC Primary

Addresses

Primary practice location

108 W Fire Tower Rd
Suite D
Winterville, NC 28590-8371

Mailing address

108 W Fire Tower Rd
Suite D
Winterville, NC 28590-8371
Phone (919) 966-0211

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
I20240228000091 NC Practitioner - Mental Health Counselor 7416392626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

108 W Fire Tower Rd
Suite D
Winterville, NC 28590-8408
Phone (252) 830-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12446NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Jan 17, 2024 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Jan 17, 2024 Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

108 W Fire Tower Rd
Ste D
Winterville, NC 28590
Phone (252) 830-3300

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, 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": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1629523188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W FIRE TOWER RD",
            "address_2": "SUITE D",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285908371",
            "telephone_number": "919-966-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W FIRE TOWER RD",
            "address_2": "SUITE D",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285908371",
            "telephone_number": "252-830-3300",
            "fax_number": "252-830-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "DANIEL",
        "middle_name": "ERNEST",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-24",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winterville, NC

Sources for this page

Verify at the official NPI Registry.