Iliana Stavans, M.A.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7350 Issued in NC

Practice address

601 E 5TH St
Suite 400
Charlotte, NC 28202-3031

Phone

(704) 332-9034

Fax

(704) 373-1604

NPI assigned

Jun 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

GKSW Crystal Group AssociatesGroup PAC ID 7810898152, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• GKSW Crystal Group Associates

  • Clinical Psychologist
  • Wyndmoor, PA
  • NPI 1568418721
  Medicare reassignment Care Compare group NPD
• United Family Services

  • Marriage & Family Therapist
  • Charlotte, NC
  • NPI 1245293315
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1710115001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 5TH ST",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282023031",
            "telephone_number": "704-332-9034",
            "fax_number": "704-373-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 5TH ST",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282023031",
            "telephone_number": "704-332-9034",
            "fax_number": "704-373-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVANS",
        "first_name": "ILIANA",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dakeita L Staton
• Jesseyetta Lavetta Staton, LCSWA
• Vanessa Maria Hawkins Staton, MA LPA
• Margaret Elizabeth Staude, SLP
• Gail Stauffer, NP-C
• Gina Thomas Stavrakas, CRNA
• Kenneth Michael Stavrakas, CRNA
• Staydry Centers LLC (StayDry Med Centers)
• Nekayah Stclair
• Pamela Lynne Stead, PHARMD

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.