Breaking Barriers Behavioral Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BREAKING BARRIERS BEHAVIORAL SERVICES LLC

Practice address

2504 Raeford Rd Ste 202
Fayetteville, NC 28305-5135

Phone

(910) 644-9986

NPI assigned

Dec 16, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Jasmine Darice Johnson, LCMHCANPI 1366924474

Title

Owner

Phone

(910) 644-9986

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jasmine Johnson, LCMHCA

  • Behavior Analyst
  • Fayetteville, NC
  • NPI 1366924474

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1104412899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 RAEFORD RD STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055135",
            "telephone_number": "910-644-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 RAEFORD RD STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055135",
            "telephone_number": "910-644-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKING BARRIERS BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "DARICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-644-9986",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCMHCA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.