Active NPI
Inner Source Therapy, PLLC
- Mental Health Counselor
- New Bern, NC
National Provider Identifier
1831867175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- INNER SOURCE THERAPY, PLLC
- Practice address
- 790 Cardinal Rd
New Bern, NC 28562-5202 - Phone
- (252) 658-0565
- Fax
- (252) 636-1100
- NPI assigned
- Sep 1, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Deborah J Ashway, LCMHC, LCAS
- Title
- Owner
- Phone
- (252) 658-0565
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
790 Cardinal Rd
New Bern, NC 28562-5202
Mailing address
261 Goose Creek Rd
New Bern, NC 28562-3667
Phone (252) 658-0565
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194134619 | Other | NC | MENTAL HEALTH THERAPISTS, LCMHC, LCAS |
| 1750886826 | Other | NC | MENTAL HEALTH THERAPISTS, LCMHC, LCAS |
| 1770780025 | Other | NC | MENTAL HEALTH THERAPISTS, LCMHC |
Other names 1
- Inner Source Therapy
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | secure.simplepractice.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240410001787 | NC | Part B Supplier - Clinic/Group Practice | 1153771787 |
Receives reassigned benefits from 4 practitioners Practice locations: New Bern, NC |
National Provider Directory
National Provider DirectoryLocations
3402 Trent Rd
New Bern, NC 28562
Phone (252) 571-6508
Practitioners & affiliated clinicians
Practitioners 11
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- New Bern, NC
- NPI 1194134619
Mental Health, NC
-
- Mental Health Counselor
- New Bern, NC
- NPI 1003154634
Mental Health, NC
-
- Addiction (Substance Use Disorder) Counselor
- Washington, NC
- NPI 1154035533
Mental Health
-
- Clinical Social Worker
- New Bern, NC
- NPI 1871336750
-
- Addiction (Substance Use Disorder) Counselor
- New Bern, NC
- NPI 1295464113
-
- Marriage & Family Therapist
- New Bern, NC
- NPI 1265370720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1630627200000",
"number": "1831867175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 GOOSE CREEK RD",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285623667",
"telephone_number": "252-658-0565",
"fax_number": "252-643-9332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 CARDINAL RD",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285625202",
"telephone_number": "252-658-0565",
"fax_number": "252-636-1100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INNER SOURCE THERAPY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-01",
"last_updated": "2021-09-03",
"certification_date": "2021-09-03",
"status": "A",
"authorized_official_last_name": "ASHWAY",
"authorized_official_first_name": "DEBORAH",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "252-658-0565",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCMHC, LCAS"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH THERAPISTS, LCMHC, LCAS",
"identifier": "1194134619",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH THERAPISTS, LCMHC, LCAS",
"identifier": "1750886826",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH THERAPISTS, LCMHC",
"identifier": "1770780025",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "secure.simplepractice.com",
"affiliation": "N",
"endpointDescription": "HIPPA Compliant softward",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "notes",
"address_1": "790 Cardinal Rd",
"city": "New Bern",
"state": "NC",
"country_code": "US",
"postal_code": "285625202",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Inner Source Therapy",
"code": "3",
"type": "Doing Business As"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.