Dedra Nichele Chavis
NPI 1376048462ActiveIndividual· Counselor, Mental Health· Fuquay Varina, NC
Counselor, Mental Health with Brightside Medical of New Jersey PC, practicing in Fuquay Varina, North Carolina. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1376048462 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Mar 29, 2018 |
| Last updated in NPPES | May 28, 2026 |
| Certified by provider | May 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Mental Health Primary | 101YM0800X | 0015151 | CO |
| Counselor, Mental Health | 101YM0800X | 21574 | NC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (NC) |
|---|
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Mental Health Counselor |
Medical group
- Brightside Medical of New Jersey PCRaleigh, NC · 66 clinicians
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All 59 mental health counselors in Fuquay Varina · All mental health counselors in North Carolina