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INNER PEACE COMMUNITY SUPPORT SERVICES LLC
NPI 1952681140
Social Worker - Clinical in Knightdale, NC

Active since August 19, 2011
3005 VILLAGE PARK DR STE 204, KNIGHTDALE, NC 27545(919) 944-3130(919) 944-3131 Get Directions Write a Review

NPPES record last updated: March 16, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Inner Peace Community Support Services Llc NPPES

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

INNER PEACE COMMUNITY SUPPORT SERVICES LLC (NPI 1952681140) is a healthcare organization registered as a clinical in Knightdale, North Carolina and active in the NPI registry since August 2011. The organization lists Darrell Tennie, Managing Director, as its authorized official.

NPPES Registry Identity

NPI1952681140
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameINNER PEACE COMMUNITY SUPPORT SERVICES LLC
Location Address3005 VILLAGE PARK DR STE 204Knightdale, NC 27545-7993
Mailing Address3005 Village Park Dr Ste 204Knightdale, NC 27545-7993 · (919) 944-3130 · Fax (919) 944-3131
Phone(919) 944-3130
Fax(919) 944-3131
Organization SubpartNo
Authorized OfficialDarrell TennieManaging Director · (919) 217-0933
Enumeration DateAugust 19, 2011
Last NPPES UpdateMarch 16, 2017
✔ NPI 1952681140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in NC · C006312✔ Licensed in SC · 9742
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3005 VILLAGE PARK DR STE 204, Knightdale, NC 27545
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Other Identifiers 3

Medicaid6008780NC
Medicare PINC450NC
MedicaidGP6439SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Inner Peace Community Support Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Inner Peace Community Support Services LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Sharon Hartzog, LCSW
Clinical Social Worker
NPI 1073714036
418 STAR RUBY DR
Knightdale, NC 27545
(919) 266-4629
✔ PECOS2.2 mi
Datanya Betts, NP
Nurse Practitioner
NPI 1639501539
LIVE WELL PRIMARY CARE 4064 BARRETT DR UNIT 9A
Raleigh, NC 27609
(919) 803-4188
✔ PECOS✔ Accepts Medicare8.9 mi
David Cook, MD
Psychiatry
NPI 1669412375
2 S MAIN ST SUITE 23
Weaverville, NC 28787
(828) 778-1690
✔ PECOS229 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Inner Peace Community Support Services LLC's NPI number?

The NPI number for Inner Peace Community Support Services LLC is 1952681140. It was assigned to this organization in the NPPES registry on August 19, 2011.

Where is Inner Peace Community Support Services LLC located?

Inner Peace Community Support Services LLC is located at 3005 Village Park Dr Ste 204, Knightdale, NC 27545. The listed phone number is (919) 944-3130.

What is Inner Peace Community Support Services LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Inner Peace Community Support Services LLC enrolled in Medicare?

Yes. Inner Peace Community Support Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Inner Peace Community Support Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Inner Peace Community Support Services LLC, in Clinical Social Worker, Nurse Practitioner and Psychiatry. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Inner Peace Community Support Services LLC was last updated on March 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.