Individual provider Active NPI

Tiffany Munoz-Santos, MS, LCMHCA

  • Mental Health Counselor
  • Fayetteville, NC
National Provider Identifier
1821739327
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A17405 Issued in NC
Practice address
1611 Owen Dr Ste B
Fayetteville, NC 28304-3425
Phone
(910) 483-5884
Fax
(910) 483-5864
NPI assigned
Apr 6, 2022
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A17405 NC Primary

Addresses

Primary practice location

1611 Owen Dr Ste B
Fayetteville, NC 28304-3425

Mailing address

4116 Fallberry Dr
Fayetteville, NC 28306-7573
Phone (907) 947-1349

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
I20250423000890 NC Practitioner - Mental Health Counselor 8426573346 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
A17405NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Consulting and Counseling of North Carolina, PLLC Mental Health CurrentSince Apr 21, 2025 Accepting new patients
Thrive Counseling & Consulting, PLLC PastSince Apr 10, 2022 Accepting new patients

Locations

2525 Raeford Rd
Ste B
Fayetteville, NC 28305
Phone (910) 261-4875

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1821739327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 FALLBERRY DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283067573",
            "telephone_number": "907-947-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 OWEN DR STE B",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-483-5884",
            "fax_number": "910-483-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ-SANTOS",
        "first_name": "TIFFANY",
        "credential": "MS, LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.