Individual provider Active NPI

Ada N Ndukwe, LPA

  • Clinical Psychologist
  • Dunn, NC
National Provider Identifier
1710147228
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4898 Issued in NC
Practice address
731 Tilghman Dr
Dunn, NC 28334-5507
Phone
(919) 390-8226
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X 8405 NC
Contractor 171W00000X 4898 NC
Clinical Psychologist 103TC0700X 4898 NC Primary

Addresses

Primary practice location

731 Tilghman Dr
Dunn, NC 28334-5507

Mailing address

2416 Diquedo Dr
Raleigh, NC 27604-1298

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
4898NCMDClinical Psychologist
8405NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tricare Counseling & Consulting, Inc. PastSince May 15, 2011 Accepting new patients

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1710147228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 DIQUEDO DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 TILGHMAN DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345507",
            "telephone_number": "919-390-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUKWE",
        "first_name": "ADA",
        "middle_name": "N",
        "credential": "LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "NC",
            "license": "8405",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NC",
            "license": "4898",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.