Organization Active NPI

Olive Branch Family Therapy, PLLC

  • Marriage & Family Therapist
  • Holly Springs, NC
National Provider Identifier
1073001970
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1922 Issued in NC
Legal business name
OLIVE BRANCH FAMILY THERAPY, PLLC
Practice address
201 Holly Springs Rd
Holly Springs, NC 27540-9023
Phone
(919) 428-7746
Fax
(919) 800-3949
NPI assigned
Apr 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Authorized official

Name
James Lawson Machado Workman, LMFTNPI 1255883385
Title
Therapist/Owner
Phone
(919) 428-7746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 1922 NC Primary

Addresses

Primary practice location

201 Holly Springs Rd
Holly Springs, NC 27540-9023

Mailing address

201 Holly Springs Rd
Holly Springs, NC 27540-9023
Phone (919) 428-7746

Other identifiers 2

IdentifierTypeStateIssuer
4541161060000OtherNCCIGNA
1255883385OtherNCBLUE CROSS BLUE SHIELD OF NORTH CAROLINA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1073001970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HOLLY SPRINGS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409023",
            "telephone_number": "919-428-7746",
            "fax_number": "919-800-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HOLLY SPRINGS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409023",
            "telephone_number": "919-428-7746",
            "fax_number": "919-800-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH FAMILY THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "MACHADO WORKMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LAWSON",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "919-428-7746",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4541161060000",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF NORTH CAROLINA",
            "identifier": "1255883385",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.