Andrea F Facci, PH.D

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC 5189 Issued in NC

Practice address

5108 N Croatan Hwy
Suite 311
Kitty Hawk, NC 27949-3988

Phone

(252) 255-1847

Fax

(252) 480-1800

NPI assigned

Mar 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1942471503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2286",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279492286",
            "telephone_number": "252-255-1847",
            "fax_number": "252-480-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 N CROATAN HWY",
            "address_2": "SUITE 311",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279493988",
            "telephone_number": "252-255-1847",
            "fax_number": "252-480-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACCI",
        "first_name": "ANDREA",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS 1057",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "LPC 5189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.