Cumberland County Communicare, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MHL-026821 Issued in NC

Legal business name

CUMBERLAND COUNTY COMMUNICARE, INC

Practice address

711B Executive PL
Fayetteville, NC 28305-5125

Phone

(910) 222-6395

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robin Jenkins, PHD

Title

Executive Director

Phone

(910) 829-9017

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

Cumberland County Communicare Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Cumberland County Communicare, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Fayetteville, NC
  • NPI 1750720397
  NPD tax ID
• Cumberland County Communicare, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Fayetteville, NC
  • NPI 1801917968
  NPD tax ID

Locations

Practitioners 3

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

• Kenneth Gregory Smith, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1356397004
  Medicare reassignment
• Robert H Jenkins, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Fayetteville, NC
  • NPI 1841342342
  NPD (past)
• Tessa Deville Moore

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1649937624
  NPD (past)

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255539870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87830",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047830",
            "telephone_number": "910-222-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711B EXECUTIVE PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055125",
            "telephone_number": "910-222-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND COUNTY COMMUNICARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-829-9017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-026821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301516Q",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301516B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301516",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cumberland Behavioral Health and Crisis Services LLC
• Cumberland Cardiology, P.a.
• Cumberland Care, Inc.
• Cumberland Chiropractic North Inc
• Cumberland Co. Hospital System Inc
• Cumberland County Communicare, Inc
• Cumberland County Communicare, Inc.
• Cumberland County Coordinating Council on Older Adults, Inc.
• Cumberland County Department of Social Services
• Cumberland County Dept of Public Health

• Community/Behavioral Health Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.