NPIMap

Organization Active NPI

Triumph LLC

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1003961269
Registry record updated Apr 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TRIUMPH LLC
Practice address
5505 Creedmoor Rd
Suite 100
Raleigh, NC 27612-6333
Phone
(919) 852-5352
Fax
(919) 852-5323
NPI assigned
Jan 25, 2007
Last updated
Apr 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Talesha Rollock
Title
Provider Enrollment Specialist
Phone
(919) 256-0824

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

5505 Creedmoor Rd
Suite 100
Raleigh, NC 27612-6333

Mailing address

3210 Fairhill Dr
Raleigh, NC 27612-3215
Phone (919) 256-0824

Other identifiers 1

IdentifierTypeStateIssuer
6005382MedicaidNC

National Provider Directory

National Provider Directory

Locations

3119 Lear Dr
#A
Burlington, NC 27215

909 S Main St
Ste A
Burlington, NC 27215

1906 E NC Highway 54
Ste 200
Durham, NC 27713
Phone (919) 405-2177

3708 Mayfair St
#2
Durham, NC 27707
Phone (919) 683-1800

705 S Mangum St
Bldg 2
Durham, NC 27701
Phone (919) 683-1041

705 S Mangum St
Bldg 3
Durham, NC 27701
Phone (919) 683-1800

725 Broad St
Durham, NC 27705
Phone (919) 433-1491

119 W Main St
Elkin, NC 28621
Phone (336) 526-8335

118 Peace St
North Wilkesboro, NC 28659
Phone (336) 667-1440

901 Jones Franklin Rd
Ste 120
Raleigh, NC 27606
Phone (919) 852-5352

1433 Georgia Ave
Roanoke Rapids, NC 27870
Phone (252) 537-6619

Practitioners & affiliated clinicians

Practitioners 68

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 68

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1003961269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 FAIRHILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123215",
            "telephone_number": "919-256-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 CREEDMOOR RD",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126333",
            "telephone_number": "919-852-5352",
            "fax_number": "919-852-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUMPH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "ROLLOCK",
        "authorized_official_first_name": "TALESHA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "919-256-0824"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005382",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.