KENETRA DEVONNE DANDRIDGE LCMHC, LCAS, CCS
NPI 1407263593
Counselor - Mental Health in Charlotte, NC
About Kenetra Devonne Dandridge Lcmhc, Lcas, Ccs NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENETRA DEVONNE DANDRIDGE LCMHC, LCAS, CCS (NPI 1407263593) is an individual mental health provider in Charlotte, North Carolina, licensed in North Carolina (15759) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kenetra Devonne Dandridge Lcmhc, Lcas, Ccs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kenetra Dandridge reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Charlotte, NC 28216
- Reassigned Medicare billing, North Carolina enrollment
- Medicare enrollment name: Novant Health Medical Group, LLC
- 2,998 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenetra Dandridge's NPI number?
The NPI number for Kenetra Dandridge is 1407263593. It was assigned to this individual provider in the NPPES registry on July 21, 2014. The provider is also known as K Devonne Moore Lcas, Lcmhc,ccs.
Where is Kenetra Dandridge located?
Kenetra Dandridge practices at 3301 Tennessee Ave, Charlotte, NC 28216. The listed phone number is (704) 900-1850.
What is Kenetra Dandridge's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kenetra Dandridge enrolled in Medicare?
Yes. Kenetra Dandridge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kenetra Dandridge's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenetra Dandridge reassigns Medicare benefits to Novant Medical Group, Inc. (Charlotte, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenetra Dandridge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kenetra Dandridge accept?
Health plans from Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc and UnitedHealthcare list Kenetra Dandridge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kenetra Dandridge was last updated on November 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenetra Devonne Dandridge, LCMHC, LCAS, CCS · NPI 1407263593
Mental Health provider in Charlotte, North Carolina. Individual provider, active in the CMS NPPES registry since July 21, 2014.
## Identity
- **NPI:** 1407263593 (Entity type: Individual)
- **Enumerated:** July 21, 2014
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 15759 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 3301 TENNESSEE AVE, Charlotte, NC 28216-4077
- **Phone:** (704) 900-1850
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Novant Medical Group, Inc. (NPI 1922627645, Charlotte, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** November 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1407263593) · Data from the CMS NPPES public registry.