NPIMap

Organization Active NPI

Family Preservation Services of North Carolina, LLC

  • Community/Behavioral Health Agency
  • Forest City, NC
National Provider Identifier
1306072061
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLC
Practice address
139 E Trade St
Forest City, NC 28043-3149
Phone
(828) 287-7945
NPI assigned
Jun 8, 2009
Last updated
Apr 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Authorized official

Name
Melissa Hedden
Title
Contract Manager
Phone
(828) 748-7629

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Psychologist 103T00000X
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Cognitive & Behavioral Psychologist 103TB0200X
Counseling Psychologist 103TC1900X
Clinical Child & Adolescent Psychologist 103TC2200X
Health Service Psychologist 103TH0100X
School Psychologist 103TS0200X
Social Worker 104100000X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

139 E Trade St
Forest City, NC 28043-3149

Mailing address

10304 Spotsylvania Ave
Fredericksburg, VA 22408-8602
Phone (540) 710-6085

Other practice location 1

127 E Trade St Ste 100
Forest City, NC 28043-2200
Phone (828) 287-7945

Other practice location 2

127 E Trade St Ste 101
Forest City, NC 28043-2200
Phone (828) 287-7945

Other identifiers 1

IdentifierTypeStateIssuer
6006085MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000148 NC Part B Supplier - Clinic/Group Practice 7214028539 Receives reassigned benefits from 15 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hendersonville, NC; Forest City, NC; Columbus, NC; Charlotte, NC; Asheville, NC

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory

Locations

127 E Trade St
Ste 101
Forest City, NC 28043
Phone (828) 287-7945

356 Charlotte Rd
Rutherfordton, NC 28139
Phone (828) 287-7945

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1306072061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 SPOTSYLVANIA AVE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088602",
            "telephone_number": "540-710-6085",
            "fax_number": "540-710-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 E TRADE ST",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280433149",
            "telephone_number": "828-287-7945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 E Trade St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Forest City",
            "state": "NC",
            "postal_code": "280432200",
            "country_code": "US",
            "telephone_number": "828-287-7945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 E Trade St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Forest City",
            "state": "NC",
            "postal_code": "280432200",
            "country_code": "US",
            "telephone_number": "828-287-7945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "HEDDEN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "828-748-7629"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006085",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.