Shiloh Child and Adolescent Day Treatment Services, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

MHL-064111 Issued in NC

Legal business name

SHILOH CHILD AND ADOLESCENT DAY TREATMENT SERVICES, LLC

Practice address

312 S Franklin St
Rocky Mount, NC 27804-5711

Phone

(252) 443-3045

Fax

(252) 443-2755

NPI assigned

Mar 29, 2010

Last updated

Mar 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Betty Plummer Brown

Title

Owner

Phone

(252) 443-3045

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1265757785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S FRANKLIN ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045711",
            "telephone_number": "252-443-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S FRANKLIN ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045711",
            "telephone_number": "252-443-3045",
            "fax_number": "252-443-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHILOH CHILD AND ADOLESCENT DAY TREATMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "PLUMMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-443-3045",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "MHL-064111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES",
            "identifier": "MHL-111",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Lee Sheldon, ED.D.
• George Shell, LPC
• Lisa Raynelle Shelley, RD, LD, CDE, BC-ADM
• Willard N Shepherd, O.D.
• Brittney Sherriod, RBT
• Gerrie Michelle Shiver, MD
• Asad Aftab Siddiqi
• Michael Sieracki, PA-C
• Wilmont Luther Sigmon, M.D.
• Mindy Rene Silcott

• Behavior Analyst in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.