Individual provider Active NPI

Olivia Ethelyn Newton

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1639761612
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8947 Issued in NC
Practice address
4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010
Phone
(910) 797-4469
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 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 8947 NC Primary

Addresses

Primary practice location

4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010

Mailing address

4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010

Other practice location 1

608 Epworth Pl
Durham, NC 27707-3371
Phone (910) 797-4469

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
I20240718003632 NC Practitioner - Mental Health Counselor 2163968744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Low Vision Rehab Solutions LLCGroup PAC ID 5496144271, 4 clinicians

Practice addresses (Care Compare)

5109 Influence Way
Raleigh, NC 27616-4345
Phone (919) 239-4805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8947NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Low Vision Rehab Solutions, LLC Mental Health CurrentSince May 22, 2025 Accepting new patients
Telos Health Systems NC PLLC CurrentSince Apr 5, 2024 Accepting new patients

Locations

550 Glenwood Dr
Mooresville, NC 28115
Phone (704) 644-4797

188 Oscar Justice Rd
Rutherfordton, NC 28139
Phone (828) 286-9001

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1639761612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 349",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 349",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010",
            "telephone_number": "910-797-4469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "608 Epworth Pl",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277073371",
            "country_code": "US",
            "telephone_number": "910-797-4469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "OLIVIA",
        "middle_name": "ETHELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.