Individual provider Active NPI

Audrey Cervero, MA, LPC

  • Mental Health Counselor
  • Conover, NC
National Provider Identifier
1891014874
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7217 Issued in NC
Practice address
715 Fairgrove Church Rd SE Ste 202
Conover, NC 28613-9289
Phone
(828) 638-5907
Fax
(828) 322-2280
NPI assigned
May 31, 2010
Last updated
Sep 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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 7217 NC Primary

Addresses

Primary practice location

715 Fairgrove Church Rd SE Ste 202
Conover, NC 28613-9289

Mailing address

715 Fairgrove Church Rd SE Ste 202
Conover, NC 28613-9289
Phone (828) 638-5907

Other identifiers 1

IdentifierTypeStateIssuer
1891014874MedicaidNC

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
I20240314003222 NC Practitioner - Mental Health Counselor 5597175455 Practice locations: Conover, NC

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

715 Fairgrove Church Rd SE
Suite 202
Conover, NC 28613-9289

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: audrey.cervero@direct.acervero.nchie.net

NPI Registry JSON

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1891014874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 FAIRGROVE CHURCH RD SE STE 202",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286139289",
            "telephone_number": "828-638-5907",
            "fax_number": "828-322-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 FAIRGROVE CHURCH RD SE STE 202",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286139289",
            "telephone_number": "828-638-5907",
            "fax_number": "828-322-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVERO",
        "first_name": "AUDREY",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-31",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891014874",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conover, NC

Sources for this page

Verify at the official NPI Registry.