Organization Active NPI

Chemical Dependence Training Evalua

  • Addiction (Substance Use Disorder) Counselor
  • Jacksonville, NC
National Provider Identifier
1083408967
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
CHEMICAL DEPENDENCE TRAINING EVALUA
Practice address
230 New Bridge St
Jacksonville, NC 28540-4708
Phone
(910) 347-4477
NPI assigned
Apr 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Authorized official

Name
Miss Cynthia BemisNPI 1205666336
Title
Owner
Phone
(910) 347-4477

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
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

230 New Bridge St
Jacksonville, NC 28540-4708

Mailing address

230 New Bridge St
Jacksonville, NC 28540-4708
Phone (910) 352-5288

Other practice location 1

405 US Highway 117 S
Burgaw, NC 28425-7742
Phone (910) 347-4477

Other practice location 2

112 Courthouse Plaza
Kenansville, NC 28349
Phone (910) 296-9696

Other identifiers 1

IdentifierTypeStateIssuer
1205666336MedicaidNC

National Provider Directory

National Provider Directory

Locations

405 US Highway 117 S
Burgaw, NC 28425
Phone (910) 347-4477

230 New Bridge St
Jacksonville, NC 28540
Phone (910) 347-4477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1083408967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 NEW BRIDGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404708",
            "telephone_number": "910-352-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 NEW BRIDGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404708",
            "telephone_number": "910-347-4477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 US Highway 117 S",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284257742",
            "country_code": "US",
            "telephone_number": "910-347-4477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 Courthouse Plaza",
            "address_purpose": "LOCATION",
            "city": "Kenansville",
            "state": "NC",
            "postal_code": "28349",
            "country_code": "US",
            "telephone_number": "910-296-9696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHEMICAL DEPENDENCE TRAINING EVALUA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "BEMIS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-347-4477",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205666336",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.