Progressive Recovery Resources LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PROGRESSIVE RECOVERY RESOURCES LLC

Practice address

3129 Creighton Dr
Charlotte, NC 28205-6209

Phone

(704) 891-6404

NPI assigned

Jun 4, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Ameer Green, BSW, QMHP,QDDP

Title

Executive Director

Phone

(704) 891-6404

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• progressive recovery resources llc Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Progressive Recovery Resources LLC

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1437491248

  O20130603000559

  Same enrollment

Locations

Practitioners 2

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

• Delores Estelle Burrill, MSW, LCSW

  • Clinical Social Worker
  • Crofton, MD
  • NPI 1750532461
  NPD
• Terry L Massey, CRTC,LCSW,LISW,CCSOT

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1508991829
  NPD (past)

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1144456104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 CREIGHTON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056209",
            "telephone_number": "704-891-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 CREIGHTON DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056209",
            "telephone_number": "704-891-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE RECOVERY RESOURCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "AMEER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-891-6404",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSW, QMHP,QDDP"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8700569",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7001430",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008234",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "progressive recovery resources llc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "progressive recovery resources llc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Case Management Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.