CMS-1500 Box 24J / 33a • NPI
1508411026
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
1041C0700X (CMS 80)
Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical
Box 32 Service Location & ZIP+4
3114 E BURMA RD, NEBO, NC, 28761-8718
✓ 9-Digit EDI 837 ZIP+4 (28761-8718)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1508411026 (TRISTAN WAYNE KILLIAN, LCSW, LCAS, CCS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1508411026 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | TRISTAN WAYNE KILLIAN, LCSW, LCAS, CCS |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical NUCC Code: 1041C0700X (Social Worker, Clinical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3114 E BURMA RD, NEBO, NC, 28761-8718 |
| Practice Telephone / Fax | Tel: (828) 201-6901 |
| Administrative Mailing Address | 356 BEAVER CREEK RD, MARION, NC, 28752-9081 |
| Enumeration & Last Sync | Enumerated: 2019-08-02 | CMS Record Updated: 2023-06-21 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (1041C0700X)
What Does Taxonomy Code 1041C0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041C0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (TRISTAN WAYNE KILLIAN, LCSW, LCAS, CCS)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101YA0400X — Counselor, Addiction (Substance Use Disorder)Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) | State: NC | License: LCAS-25220 | Primary: Secondary |
101Y00000X — CounselorPlain English: Licensed & Credentialed Counselor | State: NC | License: C015255 | Primary: Secondary |
101YP2500X — Counselor, ProfessionalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: NC | License: C015255 | Primary: Secondary |
171M00000X — Case Manager/Care CoordinatorPlain English: Licensed & Credentialed Case Manager/Care Coordinator | State: NC | License: C015255 | Primary: Secondary |
1041C0700X — Social Worker, ClinicalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical | State: NC | License: C015255 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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