Annie's House, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ANNIE'S HOUSE, LLC

Practice address

1784 Heritage Center Dr Ste 204-H
Wake Forest, NC 27587-3989

Phone

(919) 426-2146

NPI assigned

Jan 29, 2020

Last updated

Jan 29, 2020By 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

Mr. Orlander A. Bullock

Title

Chief Executive Officer

Phone

(919) 426-2146

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1275164196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1784 HERITAGE CENTER DR STE 204-H",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873989",
            "telephone_number": "919-426-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 HERITAGE CENTER DR STE 204-H",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873989",
            "telephone_number": "919-426-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNIE'S HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "ORLANDER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-426-2146",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.