NPIMap

Organization Active NPI

Carolina Choice LLC

  • Mental Health Counselor
  • Fayetteville, NC
National Provider Identifier
1215063276
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CAROLINA CHOICE LLC
Practice address
5353 Red Tip Rd
Suite 111
Fayetteville, NC 28314-1567
Phone
(910) 485-0330
Fax
(910) 482-0330
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Authorized official

Name
Ms. Donna Simon
Title
Billing Officer
Phone
(252) 633-3855

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

5353 Red Tip Rd
Suite 111
Fayetteville, NC 28314-1567

Mailing address

PO Box 12189
New Bern, NC 28561-2189
Phone (252) 633-3855

Other identifiers 3

IdentifierTypeStateIssuer
8301024MedicaidNC
8301024BMedicaidNC
8301024HMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Carolina Choice LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1215063276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12189",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612189",
            "telephone_number": "252-633-3855",
            "fax_number": "252-633-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 RED TIP RD",
            "address_2": "SUITE 111",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141567",
            "telephone_number": "910-485-0330",
            "fax_number": "910-482-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CHOICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "BILLING OFFICER",
        "authorized_official_telephone_number": "252-633-3855",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301024",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301024B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301024H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.