Active NPI
Andrea Kinnaugh, LMFT
- Marriage & Family Therapist
- Wake Forest, NC
National Provider Identifier
1881308914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2386
- Practice address
- 152 Capcom Ave
Wake Forest, NC 27587-6586 - Phone
- (919) 551-7222
- NPI assigned
- Jan 12, 2023
- Last updated
- Jan 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2386 | NC | Primary |
Addresses
Primary practice location
152 Capcom Ave
Wake Forest, NC 27587-6586
Mailing address
152 Capcom Ave
Wake Forest, NC 27587-6586
Phone (919) 551-7222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 15, 2024 through Dec 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673481600000",
"number": "1881308914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 CAPCOM AVE",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275876586",
"telephone_number": "919-551-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 CAPCOM AVE",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275876586",
"telephone_number": "919-551-7222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNAUGH",
"first_name": "ANDREA",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-12",
"last_updated": "2023-01-12",
"certification_date": "2023-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "2386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.