NPIMap

Organization Active NPI

New River Service Authority

  • Mental Health Counselor
  • Statesville, NC
National Provider Identifier
1013149665
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHL-049-108 Issued in NC
Legal business name
NEW RIVER SERVICE AUTHORITY
Practice address
524 Signal Hill Drive Ext
Statesville, NC 28625-4391
Phone
(704) 871-1045
Fax
(704) 883-8638
NPI assigned
Aug 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

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

Authorized official

Name
Patricia P Andrews
Title
Ceo
Phone
(336) 372-4095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MHL-049-108 NC Primary

Addresses

Primary practice location

524 Signal Hill Drive Ext
Statesville, NC 28625-4391

Mailing address

895 State Farm Rd
Suite 508
Boone, NC 28607-4917
Phone (828) 264-9007

Other names 1

  • New River Behavvioral Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New River Behavioral Healthcare10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250467200000",
    "number": "1013149665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 STATE FARM RD",
            "address_2": "SUITE 508",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074917",
            "telephone_number": "828-264-9007",
            "fax_number": "828-262-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254391",
            "telephone_number": "704-871-1045",
            "fax_number": "704-883-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW RIVER SERVICE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2009-08-17",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-372-4095"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "MHL-049-108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New River Behavvioral Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.