Active NPI
Community Connections Healthcare Services, LLC
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1073748992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- COMMUNITY CONNECTIONS HEALTHCARE SERVICES, LLC
- Practice address
- 5816 Creedmoor Rd Ste 104
Raleigh, NC 27612-2310 - Phone
- (919) 665-4673
- Fax
- (919) 882-8348
- NPI assigned
- May 21, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Allesha Elliott McKoy
- Title
- Executive Director
- Phone
- (919) 665-4673
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Clinical Psychologist | 103TC0700X | |||
| Clinical Social Worker | 1041C0700X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
5816 Creedmoor Rd Ste 104
Raleigh, NC 27612-2310
Mailing address
5816 Creedmoor Rd Ste 104
Raleigh, NC 27612-2310
Phone (919) 665-4673
Other practice location 1
581 Executive Pl Ste 500
Fayetteville, NC 28305-5794
Phone (910) 212-7800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6008124 | Medicaid | NC | |
| 6006833 | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Raleigh | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryLocations
5816 Creedmoor Rd
Ste 104
Raleigh, NC 27612
Phone (919) 665-4673
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Raleigh, NC
- NPI 1740361013
-
- Child & Adolescent Psychiatry Physician
- Raleigh, NC
- NPI 1467676510
-
- Behavior Technician
- Fayetteville, NC
- NPI 1306531876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623024000000",
"number": "1073748992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5816 CREEDMOOR RD STE 104",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276122310",
"telephone_number": "919-665-4673",
"fax_number": "919-882-8348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5816 CREEDMOOR RD STE 104",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276122310",
"telephone_number": "919-665-4673",
"fax_number": "919-882-8348"
}
],
"practiceLocations": [
{
"address_1": "581 Executive Pl Ste 500",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283055794",
"country_code": "US",
"telephone_number": "910-212-7800",
"fax_number": "919-882-8348",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "COMMUNITY CONNECTIONS HEALTHCARE SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-05-21",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A",
"authorized_official_last_name": "MCKOY",
"authorized_official_first_name": "ALLESHA",
"authorized_official_middle_name": "ELLIOTT",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "919-665-4673",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6008124",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6006833",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Raleigh",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5816 Creedmoor Rd Ste 104",
"city": "Raleigh",
"state": "NC",
"country_code": "US",
"postal_code": "276122310",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Raleigh, NC
- Communicare Allied Health Services
- Communicare and Associates Inc
- Communication Consultants & Associates, Inc.
- Community Adult Services, Incorporated
- Community Care Specialists & Urgent Care LLC
- Community Enrichment Services, LLC
- Community Enrichment Services, LLC.
- Community First Clinical Research, LLC
- Community Health and Wellness Center, PLLC
- Community Innovations
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.