Active NPI
Chippy Lavache
- Community/Behavioral Health Agency
- Henderson, NC
National Provider Identifier
1043631310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- MHL-032-525
- Practice address
- 630 S Garnett St
Henderson, NC 27536-4509 - Phone
- (919) 226-3180
- Fax
- (919) 226-3183
- NPI assigned
- Jan 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | MHL-032-525 | NC | Primary |
Addresses
Primary practice location
630 S Garnett St
Henderson, NC 27536-4509
Mailing address
630 S Garnett St
Henderson, NC 27536-4509
Phone (919) 226-3180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHL-032-525 | NC | MD | Community/Behavioral Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388707200000",
"number": "1043631310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 S GARNETT ST",
"city": "HENDERSON",
"state": "NC",
"postal_code": "275364509",
"telephone_number": "919-226-3180",
"fax_number": "919-226-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 S GARNETT ST",
"city": "HENDERSON",
"state": "NC",
"postal_code": "275364509",
"telephone_number": "919-226-3180",
"fax_number": "919-226-3183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVACHE",
"first_name": "CHIPPY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-03",
"last_updated": "2014-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NC",
"license": "MHL-032-525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.