Individual provider Active NPI

Deinyell Chelley, LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Reidsville, NC
National Provider Identifier
1649623869
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCAS-21214 Issued in NC
Practice address
3580 NC Highway 14
Reidsville, NC 27320-8746
Phone
(336) 522-5095
NPI assigned
Jul 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X LCAS-21214 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-21214 NC Primary

Addresses

Primary practice location

3580 NC Highway 14
Reidsville, NC 27320-8746

Mailing address

2536 McKinney St
Burlington, NC 27217-3184
Phone (336) 417-9746

Other practice location 1

2536 McKinney Street
Burlington, NC 27217
Phone (336) 417-9746

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
LCAS-21214NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alef Behavioral Group Eden, LLC Addiction (Substance Use Disorder) CurrentSince Aug 8, 2021 Accepting new patients

Locations

3580 NC Highway 14
Reidsville, NC 27320
Phone (336) 510-4235

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1649623869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 MCKINNEY ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272173184",
            "telephone_number": "336-417-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 NC HIGHWAY 14",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208746",
            "telephone_number": "336-522-5095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2536 McKinney Street",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "27217",
            "country_code": "US",
            "telephone_number": "336-417-9746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHELLEY",
        "first_name": "DEINYELL",
        "credential": "LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NC",
            "license": "LCAS-21214",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.