Christina Ayers-Klose, LCAS-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCAS-26357 Issued in NC

Practice address

10580 Ligon Mill Rd # 210
Wake Forest, NC 27587-6090

Phone

(984) 235-6786

NPI assigned

Oct 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Christina Klose Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1841897998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 COLEWAY DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404463",
            "telephone_number": "919-817-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 LIGON MILL RD # 210",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876090",
            "telephone_number": "984-235-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYERS-KLOSE",
        "first_name": "CHRISTINA",
        "credential": "LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-26357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "KLOSE",
            "credential": "LCAS-A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.