The Village Behavioral Healthcare Services, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009966 Issued in NC

Legal business name

THE VILLAGE BEHAVIORAL HEALTHCARE SERVICES, INC

Practice address

3126 Milton Rd Ste 233
Charlotte, NC 28215-3782

Phone

(704) 817-9117

Fax

(855) 299-3536

NPI assigned

May 11, 2016

Last updated

Apr 6, 2022By 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

Malik Ashhali, MSW, LCSW, LCAS, CCSNPI 1730424169

Title

Owner, Clinical Therapist

Phone

(704) 891-3481

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

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.

• Malik Ashhali, LCSW, LCAS, MAC, CSI

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1730424169

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official
• Andre Brooks, MSW, LCSWA, LCASA

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1871006973

  Addiction (Substance Use Disorder)

  NPD
• Melissa Thompson, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1558065136
  NPD

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1164878880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 MILTON RD STE 233",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153782",
            "telephone_number": "704-891-3481",
            "fax_number": "855-299-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3126 MILTON RD STE 233",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153782",
            "telephone_number": "704-817-9117",
            "fax_number": "855-299-3536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6900 Farmingdale Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282125551",
            "country_code": "US",
            "telephone_number": "704-891-3481",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 Shamrock Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282153220",
            "country_code": "US",
            "telephone_number": "704-616-9524",
            "fax_number": "704-445-4582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE VILLAGE BEHAVIORAL HEALTHCARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "ASHHALI",
        "authorized_official_first_name": "MALIK",
        "authorized_official_title_or_position": "OWNER, CLINICAL THERAPIST",
        "authorized_official_telephone_number": "704-891-3481",
        "authorized_official_credential": "MSW, LCSW, LCAS, CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3040",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.