Enjonae Anderson, MA, LCMHCS, LCAS
Individual provider Active NPI Professional Counselor · Asheboro, NC
NPI 1871843151 · NPPES record last updated Mar 3, 2023
Key facts
- NPI
- 1871843151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- S-9248 (NC)
- Practice address
- 110 W Walker Ave FL 2
Asheboro, NC 27203-6760 - Phone
- (336) 633-7000
- NPI assigned
- Sep 14, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240410000007 | NC | Practitioner - Mental Health Counselor | 2961840913 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3390 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| S-9248 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daymark Recovery Services, Inc. | Professional | Current |
Accepting new patients |
| Mended Hearts Counseling, PLLC | Current | Accepting new patients | |
| Mended Hearts Counseling | Professional | Past | Accepting new patients |
Locations
110 W Walker Ave
Fl 2
Asheboro, NC 27203
Phone (336) 633-7000
284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118
1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836
2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3390 | NC | |
| Professional Counselor | 101YP2500X | S-9248 | NC | Yes |
Addresses
Primary practice location
110 W Walker Ave FL 2
Asheboro, NC 27203-6760
Mailing address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100
Other providers in Asheboro, NC
- American Homepatient, Inc.
- Saad Amin
- Logen Joanne Amundsen
- Alton Anderson II
- Derrick Anderson
- Jacqueline Davis Anderson
- Veronica Andrade
- Erica Andrews
- Quanisha Andrews
- Anesthesia of Randolph County PA
All providers in Asheboro, NC · Professional Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.