| Dedra Nichele Chavis, | |
|
3024 White Rail Dr, Fuquay Varina, NC 27526-3695 | |
| (970) 400-1829 | |
| Not Available |
| Full Name | Dedra Nichele Chavis |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 20 Years |
| Location | 3024 White Rail Dr, Fuquay Varina, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376048462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 21574 (North Carolina) | Secondary |
| 101YM0800X | Counselor - Mental Health | 0015151 (Colorado) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Brightside Medical Of New Jersey Pc | 5799141750 | 61 |
| Entity Name | Brightside Medical of New Jersey PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811524754 PECOS PAC ID: 5799141750 Enrollment ID: O20230517000302 |
| Mailing Address | Practice Location Address |
|---|---|
| Dedra Nichele Chavis, 3024 White Rail Dr, Fuquay Varina, NC 27526-3695 Ph: (970) 400-1829 | Dedra Nichele Chavis, 3024 White Rail Dr, Fuquay Varina, NC 27526-3695 Ph: (970) 400-1829 |
Judy Klimcheck, Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Sunset Dr, Fuquay Varina, NC 27526 Phone: 919-787-6131 Fax: 919-571-2932 |
Kelly Zander, LCMHCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1441 E Broad St Ste 112, Fuquay Varina, NC 27526 Phone: 919-275-0456 |
Jennifer L Bock, Counselor Medicare: Not Enrolled in Medicare Practice Location: Po Box 452, Fuquay Varina, NC 27526 Phone: 910-381-3465 |
Brittany N Starbuck, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Academy St, Fuquay Varina, NC 27526 Phone: 919-980-5312 |
Susanne Christine Tafalla, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7629 Purfoy Rd, Fuquay Varina, NC 27526 Phone: 919-285-4802 |
Melissa Register Meyers, M.ED., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Academy St Ste 303, Fuquay Varina, NC 27526 Phone: 910-916-6404 Fax: 910-390-6039 |
Clara M Stiers, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8132 Robincrest Ct, Fuquay Varina, NC 27526 Phone: 919-552-3467 |