NPIMap

Organization Active NPI

Southeastern Regional Mental Health

  • Counselor
  • Lumberton, NC
National Provider Identifier
1184768202
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
SOUTHEASTERN REGIONAL MENTAL HEALTH
Practice address
450 Country Club Rd
Lumberton, NC 28360-9494
Phone
(910) 272-1230
Fax
(910) 738-8230
NPI assigned
Feb 20, 2007
Last updated
Feb 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Authorized official

Name
Mrs. Vicki Evans
Title
Finance Officer
Phone
(910) 272-1230

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

450 Country Club Rd
Lumberton, NC 28360-9494

Mailing address

450 Country Club Rd
Lumberton, NC 28360-9494
Phone (910) 272-1230

Other identifiers 1

IdentifierTypeStateIssuer
6005444MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Regional Mental Health Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1184768202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 COUNTRY CLUB RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283609494",
            "telephone_number": "910-272-1230",
            "fax_number": "910-738-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 COUNTRY CLUB RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283609494",
            "telephone_number": "910-272-1230",
            "fax_number": "910-738-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN REGIONAL MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "910-272-1230",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005444",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.