| Advaita Integrated Medicine PLLC | |
|
4904 Professional Ct Raleigh NC 27609-4969 | |
| (919) 893-4465 | |
| (919) 689-5350 |
| Full Name | Advaita Integrated Medicine PLLC |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4904 Professional Ct, Raleigh, North Carolina |
| Authorized Official Name and Position | J Eulan Johnson (CEO) |
| Authorized Official Contact | 8282286148 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advaita Integrated Medicine PLLC 4904 Professional Ct Raleigh NC 27609-4969 Ph: (919) 893-4465 | Advaita Integrated Medicine PLLC 4904 Professional Ct Raleigh NC 27609-4969 Ph: (919) 893-4465 |
| NPI Number | 1437727088 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 08/05/2026 |
| Certification Date | 08/05/2026 |
| Medicare PECOS PAC ID | 4385023043 |
|---|---|
| Medicare Enrollment ID | O20220627001513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437727088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | () | Primary |
| Provider Name | Elizabeth M Kaczor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730179938 PECOS PAC ID: 2769531227 Enrollment ID: I20090513000178 |
| Provider Name | Caroline T Barndt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891136578 PECOS PAC ID: 2466763222 Enrollment ID: I20150619000979 |
| Provider Name | Kelly Crenshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790161263 PECOS PAC ID: 4183933732 Enrollment ID: I20151021001418 |
| Provider Name | Lori Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316467749 PECOS PAC ID: 4385916154 Enrollment ID: I20170815001687 |
| Provider Name | Daniel Wurzelmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356780662 PECOS PAC ID: 4981914009 Enrollment ID: I20171017002755 |
| Provider Name | Mari-jane Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356718308 PECOS PAC ID: 6204123987 Enrollment ID: I20180110000564 |
| Provider Name | Roy Dewayne Book |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245437631 PECOS PAC ID: 1951648286 Enrollment ID: I20190124002596 |
| Provider Name | Alexandra L Spessot |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073789764 PECOS PAC ID: 5991821845 Enrollment ID: I20190227001160 |
| Provider Name | Jessica Anne Curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295123925 PECOS PAC ID: 0042539777 Enrollment ID: I20190603002850 |
| Provider Name | Lindsay Hildreth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740843234 PECOS PAC ID: 6800120908 Enrollment ID: I20190624002077 |
| Provider Name | Corey C Kennedy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811410483 PECOS PAC ID: 8022340348 Enrollment ID: I20191105002818 |
| Provider Name | James Oliver Dowd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881241958 PECOS PAC ID: 0244665479 Enrollment ID: I20200116001995 |
| Provider Name | Timothy Joseph Oconnor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285081711 PECOS PAC ID: 7113211442 Enrollment ID: I20200904000118 |
| Provider Name | Andrew Howland Fish |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629526488 PECOS PAC ID: 0345657581 Enrollment ID: I20210406000126 |
| Provider Name | Laura Elizabeth Downey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598388647 PECOS PAC ID: 2163811191 Enrollment ID: I20211115000066 |
| Provider Name | Henry Paul Pfeifer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598478281 PECOS PAC ID: 2466827241 Enrollment ID: I20230410000125 |
| Provider Name | Michael Holsten |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700294899 PECOS PAC ID: 7618257494 Enrollment ID: I20240614000152 |
| Provider Name | Rachel Iroff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700630134 PECOS PAC ID: 7113463167 Enrollment ID: I20240725003670 |
| Provider Name | Devon James Zafuto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497497150 PECOS PAC ID: 7911447677 Enrollment ID: I20240909002054 |
| Provider Name | Seton Smiell-koons Ennis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841053469 PECOS PAC ID: 2365982832 Enrollment ID: I20240911000738 |
| Provider Name | Kristen Poppe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568236982 PECOS PAC ID: 9537677851 Enrollment ID: I20250806001502 |
| Provider Name | Kelli Matsievskiy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962022855 PECOS PAC ID: 1456850486 Enrollment ID: I20250818001545 |
| Provider Name | Deana Marie Luciano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629773924 PECOS PAC ID: 5799286225 Enrollment ID: I20250827003674 |
| Provider Name | Connor Moss Belson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801478516 PECOS PAC ID: 1153730940 Enrollment ID: I20251017000523 |
| Provider Name | Kylie Nesta Hoover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669210589 PECOS PAC ID: 7719478601 Enrollment ID: I20251119000342 |
| Provider Name | Diane Mason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497335541 PECOS PAC ID: 1355836214 Enrollment ID: I20251218003067 |
| Provider Name | Lydia Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093449068 PECOS PAC ID: 2769953157 Enrollment ID: I20260605003707 |
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