NPIMap

Organization Active NPI

Wake Teen Medical Services Inc.

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1285819946
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WAKE TEEN MEDICAL SERVICES INC.
Practice address
505 Oberlin Rd
Suite 204
Raleigh, NC 27605-1397
Phone
(919) 828-0035
Fax
(919) 828-0355
NPI assigned
Dec 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

Name
Ms. Joyce S. Wood
Title
Executive Director
Phone
(919) 828-0035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

505 Oberlin Rd
Suite 204
Raleigh, NC 27605-1397

Mailing address

505 Oberlin Rd
Suite 204
Raleigh, NC 27605-1397
Phone (919) 828-0035

Other identifiers 1

IdentifierTypeStateIssuer
6005424MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Wake Teen Medical 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.

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1285819946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 OBERLIN RD",
            "address_2": "SUITE 204",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051397",
            "telephone_number": "919-828-0035",
            "fax_number": "919-828-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 OBERLIN RD",
            "address_2": "SUITE 204",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051397",
            "telephone_number": "919-828-0035",
            "fax_number": "919-828-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE TEEN MEDICAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-828-0035",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005424",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.