Individual provider Active NPI

Antoinette Morris

  • Professional Counselor
  • Fayetteville, NC
National Provider Identifier
1770880312
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8533 Issued in NC
Practice address
103 Country Club Dr
Fayetteville, NC 28301-7603
Phone
(910) 400-7002
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8533 NC Primary

Addresses

Primary practice location

103 Country Club Dr
Fayetteville, NC 28301-7603

Mailing address

PO Box 746724
Atlanta, GA 30374-6724
Phone (312) 733-9730

Other practice location 1

5707 Danville Dr
Fayetteville, NC 28311-3419
Phone (910) 822-2706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20240315003641 NC Practitioner - Mental Health Counselor 7810333580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

103 Country Club Dr
Fayetteville, NC 28301-7603
Phone (910) 400-7002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8533NCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina CurrentSince Feb 1, 2024 Accepting new patients
Osh-Mi Physicians Group PC CurrentSince Aug 5, 2024 Accepting new patients
Best Day Psychiatry and Counseling, PC CurrentSince Feb 10, 2024 Accepting new patients
Best Day Psychiatry and Counseling, PC Professional CurrentSince Feb 10, 2024 Accepting new patients
Lifesource of North Carolina CurrentSince Feb 1, 2024 Accepting new patients
Osh Mi Physicians Group, PC CurrentSince Aug 5, 2024 Accepting new patients
Moving Forward Individual and Family Therapy, PLLC Current Accepting new patients

Locations

3250 Freedom Dr
Charlotte, NC 28208
Phone (704) 394-0118

2587 Ravenhill Dr
Fayetteville, NC 28303
Phone (910) 323-1545

103 Country Club Dr
Fayetteville, NC 28301
Phone (910) 400-7002

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

Organizations & group practices 7

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1770880312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746724",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746724",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 COUNTRY CLUB DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283017603",
            "telephone_number": "910-400-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5707 Danville Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283113419",
            "country_code": "US",
            "telephone_number": "910-822-2706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "ANTOINETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.