MS. SHANATA N EDWARDS LCMHCA, LCAS-A
NPI 1619654415
Counselor - Professional in Rocky Point, NC

Active since July 03, 2023PECOS EnrolledAccepts Medicare Assignment
7910 US HWY 117 S, ROCKY POINT, NC 28457(910) 259-0668 Get Directions Write a Review

NPPES record last updated: June 11, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 11, 2024, Jul 3, 2023 (2 updates tracked since 2023).

About Ms. Shanata N Edwards Lcmhca, Lcas-a NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SHANATA N EDWARDS LCMHCA, LCAS-A (NPI 1619654415) is an individual professional provider in Rocky Point, North Carolina, licensed in North Carolina (A19627) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1619654415
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. SHANATA N EDWARDSCredential: LCMHCA, LCAS-A
Location Address7910 US HWY 117 SRocky Point, NC 28457-9431
Mailing Address615 Shipyard BlvdWilmington, NC 28412-6431 · (910) 343-0145 · Fax (910) 341-5779
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 3, 2023
Last NPPES UpdateJune 11, 20242 updates tracked since enumeration
NPPES CertifiedJune 11, 2024
NPI 1619654415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in NC · A19627
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LCAS-29061 (NC)
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License A19627 (NC)
7910 US HWY 117 S, Rocky Point, NC 28457

Secondary Practice Locations 2

Location 1416 West Ridge StreetRose Hill, NC 28458 · Phone (910) 289-2610
Location 2615 Shipyard BlvdWilmington, NC 28412-6431 · Phone (910) 343-0145 · Fax (910) 341-5779

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Shanata N Edwards Lcmhca, Lcas-a 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.

PECOS PAC ID2062929201
PECOS Enrollment IDI20250730003990
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
7910 US HWY 117 S, UNIT 120
ROCKY POINT, NC 28457
Community/Behavioral Health
7910 US HWY 117 S
ROCKY POINT, NC 28457
Family Medicine
7910 US HWY 117 S
ROCKY POINT, NC 28457
Physician Assistant
7910 US HWY 117 S, UNIT 120
ROCKY POINT, NC 28457
Physician Assistant
7910 US HWY 117 S, UNIT 120
ROCKY POINT, NC 28457
Social Worker (Clinical)
7910 US HWY 117 S
ROCKY POINT, NC 28457
Social Worker (Clinical)
7910 US HWY 117 S
ROCKY POINT, NC 28457
Counselor (Professional)
7910 US HWY 117 S
ROCKY POINT, NC 28457

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619654415, enumerated as an "individual" on July 03, 2023.

The provider is located at 7910 US HWY 117 S ROCKY POINT, NC 28457 and the phone number is (910) 259-0668.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.