NPIMap

Organization Active NPI

Dream Provider Care Services

  • Community/Behavioral Health Agency
  • Edenton, NC
National Provider Identifier
1194005256
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL007036 Issued in NC
Legal business name
DREAM PROVIDER CARE SERVICES
Doing business as
Dream Provider Care Services
Practice address
703 N Broad Street
Dream Provider Care Services
Edenton, NC 27932-0703
Phone
(252) 946-0585
Fax
(252) 946-0580
NPI assigned
Aug 22, 2011
Last updated
May 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

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

Authorized official

Name
Wendee M Bailey
Title
Owner.
Phone
(252) 946-0585

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Social Worker 1041C0700X NU
Community/Behavioral Health Agency 251S00000X MHL007036 NC Primary

Addresses

Primary practice location

703 N Broad Street
Dream Provider Care Services
Edenton, NC 27932-0703

Mailing address

216 Stewart Pkwy
Dream Provider Care Services, Inc.
Washington, NC 27889-4972
Phone (252) 946-0585

Other identifiers 1

IdentifierTypeStateIssuer
6005782MedicaidNC

Other names 1

  • Dream Provider Care Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dream Provider Care Services Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495065600000",
    "number": "1194005256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 STEWART PKWY",
            "address_2": "DREAM PROVIDER CARE SERVICES, INC.",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894972",
            "telephone_number": "252-946-0585",
            "fax_number": "252-946-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N BROAD STREET",
            "address_2": "DREAM PROVIDER CARE SERVICES",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279320703",
            "telephone_number": "252-946-0585",
            "fax_number": "252-946-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAM PROVIDER CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2017-05-18",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "WENDEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER.",
        "authorized_official_telephone_number": "252-946-0585"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL007036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005782",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dream Provider Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edenton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; 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.