NPIMap

Organization Active NPI

Tyson'S Corner Health Services, Inc.

  • Counselor
  • Rocky Mount, NC
National Provider Identifier
1265713606
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
TYSON'S CORNER HEALTH SERVICES, INC.
Practice address
600 N Grace St
Unit D
Rocky Mount, NC 27804-4843
Phone
(252) 407-8469
NPI assigned
Aug 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Ms. Caspertine Hawkins
Title
Ceo
Phone
(252) 407-8469

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X Primary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Community/Behavioral Health Agency 251S00000X NC

Addresses

Primary practice location

600 N Grace St
Unit D
Rocky Mount, NC 27804-4843

Mailing address

2100 N Heritage St
Unit B
Kinston, NC 28501-2222
Phone (252) 407-8469

Other identifiers 2

IdentifierTypeStateIssuer
6008809MedicaidNC
5921354MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Tyson'S Corner Health Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2100 N Herritage St
#B
Kinston, NC 28501

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1265713606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N HERITAGE ST",
            "address_2": "UNIT B",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285012222",
            "telephone_number": "252-407-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GRACE ST",
            "address_2": "UNIT D",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278044843",
            "telephone_number": "252-407-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYSON'S CORNER HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "CASPERTINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-407-8469",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008809",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921354",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.