Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dedra Nichele Chavis

Individual provider Mental Health Counselor · NPI 1376048462

Dedra Nichele Chavis is a Mental Health Counselor in Fuquay Varina, North Carolina. Qualified in 2006, 20 years ago. Practices with Brightside Medical of New Jersey PC, a 61-clinician group and accepts Medicare assignment. Licensed in Colorado and North Carolina.

Years since qualifying
20
Licensed in
CO, NC
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

3024 White Rail Dr
Fuquay Varina, NC 27526-3695
Phone: (970) 400-1829
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 0015151 (CO)
Mental Health Counselor Taxonomy 101YM0800X · Licence 21574 (NC)

Record details

NPI number1376048462
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 29, 2018
Last updated in NPPESMay 28, 2026
Certification dateMay 28, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Brightside Medical Of New Jersey Pc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fuquay Varina