Active NPI
Justin Paul Acebo, LPC, NCC, MS
- Mental Health Counselor
- Raleigh, NC
National Provider Identifier
1992951545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6992
- Practice address
- 5554 Nur Lane
Raleigh, NC 27606-4060 - Phone
- (919) 902-9600
- NPI assigned
- Aug 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6992 | NC | Primary |
| Professional Counselor | 101YP2500X | 6992 | NC |
Addresses
Primary practice location
5554 Nur Lane
Raleigh, NC 27606-4060
Mailing address
2664 Timber Drive
Suite 150
Garner, NC 27529
Phone (919) 902-9600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6992 | Other | NC | NCBLPC LICENSE NUMBER |
| 6104000 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6992 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346976000000",
"number": "1992951545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2664 TIMBER DRIVE",
"address_2": "SUITE 150",
"city": "GARNER",
"state": "NC",
"postal_code": "27529",
"telephone_number": "919-902-9600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5554 NUR LANE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276064060",
"telephone_number": "919-902-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACEBO",
"first_name": "JUSTIN",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "LPC, NCC, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-14",
"last_updated": "2012-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "6992",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "6992",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCBLPC LICENSE NUMBER",
"identifier": "6992",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6104000",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.