Active NPI
Coby Crandall, CPSS
- Mental Health Counselor
- Raleigh, NC
National Provider Identifier
1730638255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 211 Ashe Ave
27
Raleigh, NC 27605-1877 - Phone
- (919) 675-2443
- NPI assigned
- Sep 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 2016-3282-01 | NC | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
211 Ashe Ave
27
Raleigh, NC 27605-1877
Mailing address
211 Ashe Ave
27
Raleigh, NC 27605-1877
Phone (919) 675-2443
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2016-3282-01 | NC | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496880000000",
"number": "1730638255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 ASHE AVE",
"address_2": "27",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276051877",
"telephone_number": "919-675-2443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 ASHE AVE",
"address_2": "27",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276051877",
"telephone_number": "919-675-2443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "COBY",
"name_prefix": "Mr.",
"credential": "CPSS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-26",
"last_updated": "2017-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NC",
"license": "2016-3282-01",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.