Belisa Fasha Kershaw, LCMHC
Individual provider Active NPI Mental Health Counselor · Fayetteville, NC
NPI 1669933917 · NPPES record last updated May 2, 2022
Key facts
- NPI
- 1669933917
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 14726 (NC)
- Practice address
- 901 Arsenal Ave Ste 202
Fayetteville, NC 28305-5478 - Phone
- (910) 323-3368
- Fax
- (910) 486-7000
- NPI assigned
- Mar 28, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Biblical Counseling Services
Practice addresses (Care Compare)
901 Arsenal Ave
Suite 202
Fayetteville, NC 28305-5478
Phone (910) 323-3368
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240307000788 | NC | Practitioner - Mental Health Counselor | 1355787805 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14726 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Opportunities Industrialization Center, Inc | Current |
Accepting new patients | |
| Biblical Counseling Services | Mental Health | Current |
Accepting new patients |
| Opportunities Industrialization Center, Inc. | Current |
Accepting new patients |
Locations
901 Arsenal Ave
Ste 201
Fayetteville, NC 28305
Phone (910) 323-3368
901 Arsenal Ave
Ste 202
Fayetteville, NC 28305
Phone (910) 323-3368
90 Guardian Ct
Rocky Mount, NC 27804
Phone (252) 212-3350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 14726 | NC | |
| Mental Health Counselor | 101YM0800X | 14726 | NC | Yes |
Addresses
Primary practice location
901 Arsenal Ave Ste 202
Fayetteville, NC 28305-5478
Mailing address
901 Arsenal Ave Ste 202
Fayetteville, NC 28305-5478
Phone (910) 323-3368
Other providers in Fayetteville, NC
- Brian Tyler Kern
- Connie Kern
- David Livingstone Kerr IV
- Nancy Lynn Kerr
- Naomi Delois Kerr
- Katherine Anne Kessler
- Laura Kessler
- Heatherlee Kesterson
- Christopher John Ketchman
- Markandu Ketheeswaran
All providers in Fayetteville, NC · Mental Health Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.