Organization Active NPI

Roosevelt's Character Development Center

  • Cognitive & Behavioral Psychologist
  • Statesboro, GA
National Provider Identifier
1083070718
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Legal business name
ROOSEVELT'S CHARACTER DEVELOPMENT CENTER
Practice address
119 S College St
Statesboro, GA 30458-5202
Phone
(912) 541-2809
NPI assigned
Jan 11, 2016
Last updated
Jan 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Authorized official

Name
Mr. Roosevelt Cone Jr.
Title
Owner
Phone
(912) 541-2809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X NU Primary

Addresses

Primary practice location

119 S College St
Statesboro, GA 30458-5202

Mailing address

119 S College St
Statesboro, GA 30458-5202
Phone (912) 541-2809

Other names 1

  • RCDC Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1083070718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S COLLEGE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585202",
            "telephone_number": "912-541-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S COLLEGE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585202",
            "telephone_number": "912-541-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT'S CHARACTER DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "CONE",
        "authorized_official_first_name": "ROOSEVELT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-541-2809",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RCDC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.