NPIMap

Organization Active NPI

Family Service of the Piedmont, Inc.

  • Mental Health Counselor
  • High Point, NC
National Provider Identifier
1073154514
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAMILY SERVICE OF THE PIEDMONT, INC.
Practice address
308 Boulevard St
High Point, NC 27262-3802
Phone
(336) 889-6105
Fax
(336) 387-9167
NPI assigned
Oct 7, 2019
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Stacey Ann Brown
Title
Contracts Administrator
Phone
(336) 889-6105

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU Primary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Nurse Practitioner 363L00000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

308 Boulevard St
High Point, NC 27262-3802

Mailing address

902 Bonner Dr
Jamestown, NC 27282-8948
Phone (336) 889-6105

Other identifiers 1

IdentifierTypeStateIssuer
1871672550MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100818001335 NC Part B Supplier - Clinic/Group Practice 8426182965 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: High Point, NC; Greensboro, NC; Asheboro, NC

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Family Service of the Piedmont18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

513 White Oak St
Ste C
Asheboro, NC 27203
Phone (336) 633-1845

308 Boulevard St
High Point, NC 27262
Phone (336) 801-1188

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1073154514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BONNER DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828948",
            "telephone_number": "336-889-6105",
            "fax_number": "336-387-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 BOULEVARD ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623802",
            "telephone_number": "336-889-6105",
            "fax_number": "336-387-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE OF THE PIEDMONT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CONTRACTS ADMINISTRATOR",
        "authorized_official_telephone_number": "336-889-6105"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871672550",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.