Beatitude House

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

996 Issued in NC

Legal business name

BEATITUDE HOUSE

Practice address

470 Twin Brook Dr
Waynesville, NC 28785-8348

Phone

(828) 926-5591

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Matthew H Bradley IV, MSWNPI 1588193130

Title

President

Phone

(828) 926-5591

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Matthew Henry Bradley IV, MSW , LMFT

  • Marriage & Family Therapist
  • Waynesville, NC
  • NPI 1588193130
  NPD (past) Authorized official

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1144308396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 TWIN BROOK DR",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287858348",
            "telephone_number": "828-926-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 TWIN BROOK DR",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287858348",
            "telephone_number": "828-926-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEATITUDE HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-926-5591",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "136YF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6105027",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Waynesville, NC
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.