Loving Reconnections Behavioral Health PA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C010334 Issued in NC

Legal business name

LOVING RECONNECTIONS BEHAVIORAL HEALTH PA

Practice address

110 Hepler St
Suite B
Kernersville, NC 27284-2791

Phone

(336) 497-5701

NPI assigned

Oct 7, 2016

Last updated

Jan 23, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Vincent Governale

Title

Practice Manager / Vice President

Phone

(336) 497-5701

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

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.

• Joann Marie Governale, BA PSY, MSW, LCSW

  • Clinical Social Worker
  • Belews Creek, NC
  • NPI 1568709756
  Medicare reassignment Care Compare group NPD
• Rebecca Kaye Jackson, MSW, LCSW

  • Clinical Social Worker
  • King, NC
  • NPI 1447702063
  Medicare reassignment Care Compare group NPD
• Sarah A. Solomon, LCSW

  • Clinical Social Worker
  • King, NC
  • NPI 1144576810
  Medicare reassignment Care Compare group NPD
• James Moses, LCSWA

  • Clinical Social Worker
  • Winston Salem, NC
  • NPI 1851760516
  Medicare reassignment NPD
• Arvay Ross, MA, LCMHC, LCAS

  • Professional Counselor
  • Lexington, NC
  • NPI 1710563788

  Community/Behavioral Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1053861641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HEPLER ST",
            "address_2": "SUITE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842791",
            "telephone_number": "336-497-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HEPLER ST",
            "address_2": "SUITE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842791",
            "telephone_number": "336-497-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVING RECONNECTIONS BEHAVIORAL HEALTH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "GOVERNALE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRACTICE MANAGER / VICE PRESIDENT",
        "authorized_official_telephone_number": "336-497-5701",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "C010334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Lopez, LPTA
• Kashia Lor
• Mallory McCormack Loser, NP
• Cassidy Louwerens
• Renn Lovett, MD
• Jennifer Lowe, CPHT
• Devereux Luck
• Lung and Sleep Wellness Center PC
• Kellie Marie Lutgen, PHARMD
• Kao Jalao Ly, NP

• Community/Behavioral Health Agency in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.