Chemical Dependency Services, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

MHL-090-162 Issued in NC

Legal business name

CHEMICAL DEPENDENCY SERVICES, INC

Practice address

308 W. Windsor Street
Monroe, NC 28112-4779

Phone

(704) 289-4887

Fax

(704) 289-5188

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Walter Lyndon Beck III

Title

Director

Phone

(704) 289-4877

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Chemical Dependency & Court Services Other name

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1306062856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 W. WINDSOR STREET",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124779",
            "telephone_number": "704-289-4887",
            "fax_number": "704-289-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W. WINDSOR STREET",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124779",
            "telephone_number": "704-289-4887",
            "fax_number": "704-289-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEMICAL DEPENDENCY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "LYNDON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-289-4877",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "MHL-090-058",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "MHL-090-162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MHL-090-058",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "050089",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DWI PROVIDER",
            "identifier": "50315",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chemical Dependency & Court Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Monroe, NC
• Providers in Monroe, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.