Organization Active NPI

Santana Therapy & Counseling, PLLC

  • Community/Behavioral Health Agency
  • Wake Forest, NC
National Provider Identifier
1922648633
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SANTANA THERAPY & COUNSELING, PLLC
Practice address
1788 Heritage Center Dr
Wake Forest, NC 27587-3948
Phone
(919) 399-9114
NPI assigned
Jan 10, 2020
Last updated
Oct 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Evelyn Artemis Knez, LCSWNPI 1053755884
Title
Clinical Therapist
Phone
(919) 298-0166

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1788 Heritage Center Dr
Wake Forest, NC 27587-3948

Mailing address

1788 Heritage Center Dr
Wake Forest, NC 27587-3948
Phone (919) 399-9114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221221000640 NC Part B Supplier - Clinic/Group Practice 3870963580 Receives reassigned benefits from 1 practitioner
Practice locations: Wake Forest, NC

National Provider Directory

National Provider Directory

Locations

1788 Heritage Center Dr
Wake Forest, NC 27587
Phone (919) 399-9114

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1922648633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 HERITAGE CENTER DR",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873948",
            "telephone_number": "919-399-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 HERITAGE CENTER DR",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873948",
            "telephone_number": "919-399-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTANA THERAPY & COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "KNEZ",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "ARTEMIS",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "919-298-0166",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "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 Oct 7, 2024; 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.

Verify at the official NPI Registry.