Clinical Services Associates, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C004369 Issued in NC

Legal business name

CLINICAL SERVICES ASSOCIATES, LLC

Practice address

111 Lamon St Ste 212
Fayetteville, NC 28301-4957

Phone

(910) 429-2222

NPI assigned

May 31, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doris Ann Moore-Russell, MSW LCSWNPI 1255321592

Title

Partner

Phone

(910) 429-2222

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Doris Ann Moore-Russell, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1255321592
  NPD (past) Authorized official
• Teresa Elliott

  • Mental Health Counselor
  • Fayetteville, NC
  • NPI 1407171887
  NPD (past)
• Andrea Maria Hamer, MSW, P-LCSW

  • Social Worker
  • Fayetteville, NC
  • NPI 1508181611
  NPD (past)
• Katrina Ann Watford Gamble, MA,NCC,LPC

  • Counselor
  • Fayetteville, NC
  • NPI 1124175500
  NPD (past)

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134320427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAMON ST STE 212",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAMON ST STE 212",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014957",
            "telephone_number": "910-429-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL SERVICES ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE-RUSSELL",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "910-429-2222",
        "authorized_official_credential": "MSW LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C004369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Clifton
• Marie Alexandra Clincy, NP
• Dorothy Jacobyansky Cline
• Elizabeth G Cline, CCC-SLP
• Clinical Counseling and Consulting Services, PLLC
• Robert Allen Clinton Jr., M.D.
• Ashley Grace Clocher, MSW, LCSW
• David A Cloud, CPED
• Carrie Mae Clough, FNP-BC
• Hollie Clouse, COTA/L

• 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 Aug 22, 2020; 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.