Physician Alliance for Mental Health, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHYSICIAN ALLIANCE FOR MENTAL HEALTH, LLC

Practice address

3208 Oleander Drive
Wilmington, NC 28403-0800

Phone

(910) 794-3929

Fax

(910) 798-2303

NPI assigned

Sep 6, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Wendy Rene Kaczynski

Title

Provider Manager

Phone

(910) 262-7107

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 8

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

• Brett A Gurkin, M.D.

  • Psychiatry Physician
  • Wilmington, NC
  • NPI 1053355719
  Medicare reassignment Care Compare group
• Geoffrey Devries Holland, P.A.

  • Physician Assistant
  • Wilmington, NC
  • NPI 1528126166
  Medicare reassignment Care Compare group
• Katherine Martin, LCSW

  • Clinical Social Worker
  • Wilmington, NC
  • NPI 1871861831
  Medicare reassignment Care Compare group
• Christopher Robert Myers, M.D.

  • Psychiatry Physician
  • Wilmington, NC
  • NPI 1003905670
  Medicare reassignment Care Compare group
• Amanda Spytkowski, NP

  • Family Nurse Practitioner
  • Wilmington, NC
  • NPI 1285237677
  Medicare reassignment NPD
• Pamela J Wenning, FNP

  • Family Nurse Practitioner
  • Wilmington, NC
  • NPI 1902021769
  Medicare reassignment NPD
• Leighton Danielle Morgan, PA-C

  • Physician Assistant
  • Wilmington, NC
  • NPI 1285003285
  Medicare reassignment
• Patricia Prichard, LCSWA

  • Clinical Social Worker
  • Wilmington, NC
  • NPI 1790217156
  NPD

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1285882928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15511",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085511",
            "telephone_number": "910-794-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 OLEANDER DRIVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284030800",
            "telephone_number": "910-794-3929",
            "fax_number": "910-798-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ALLIANCE FOR MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-06",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "KACZYNSKI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "PROVIDER MANAGER",
        "authorized_official_telephone_number": "910-262-7107",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Panida Piboolnurak, MD
• Kelly Broadwater Pickell, MA, LPA, LPC, CEDS
• Tynisha Jeanette Pickett

• Community/Behavioral Health Agency in Wilmington, NC
• Providers in Wilmington, 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 Dec 17, 2015; 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.