Individual provider Active NPI

Dwayne Thomas Lawrence, LCMHC, LCAS

  • Professional Counselor
  • Greenville, NC
National Provider Identifier
1801908678
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7328 Issued in NC
Practice address
413 Paladin Dr Apt D
Greenville, NC 27834-7745
Phone
(252) 341-3192
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X 7328 NC Primary

Addresses

Primary practice location

413 Paladin Dr Apt D
Greenville, NC 27834-7745

Mailing address

413 Paladin Dr Apt D
Greenville, NC 27834-7745
Phone (252) 341-3192

Other identifiers 1

IdentifierTypeStateIssuer
6111884MedicaidNC

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
I20240304002463 NC Practitioner - Mental Health Counselor 2668817313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Adio/Pennsylvania Institute of Straight Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A Fresh Start Behavioral Health Services, PLLCGroup PAC ID 9931466646, 6 clinicians

Practice addresses (Care Compare)

2407 Grace Ave
New Bern, NC 28562-4416
Phone (252) 638-0185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A Fresh Start Behavioral Health Services, PLLC CurrentSince Jan 22, 2024 Accepting new patients
Imperial Counseling & Coaching Services, LLC Past Accepting new patients

Locations

2407 Grace Ave
Trent Woods, NC 28562
Phone (252) 514-7766

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1801908678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 PALADIN DR APT D",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347745",
            "telephone_number": "252-341-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 PALADIN DR APT D",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347745",
            "telephone_number": "252-341-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "DWAYNE",
        "middle_name": "THOMAS",
        "credential": "LCMHC, LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111884",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.