New River Service Authority

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NEW RIVER SERVICE AUTHORITY

Practice address

320 E Lee Ave
Yadkinville, NC 27055-8132

Phone

(336) 679-8805

Fax

(828) 262-5687

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

Patricia P Andrews, LPC

Title

Ceo

Phone

(336) 372-4095

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New River Behavioral HealthCare Doing business as

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1114197993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 STATE FARM RD",
            "address_2": "SUITE 508",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074917",
            "telephone_number": "828-263-5666",
            "fax_number": "828-262-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558132",
            "telephone_number": "336-679-8805",
            "fax_number": "828-262-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW RIVER SERVICE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-372-4095",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2329286",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New River Behavioral HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Yadkinville, NC
• Providers in Yadkinville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.