Advance Intergrated Mentoring

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

2827-A Issued in NC

Legal business name

ADVANCE INTERGRATED MENTORING

Practice address

205 S Skipper St
Rockingham, NC 28379-3843

Phone

(336) 404-2110

NPI assigned

May 13, 2015

Last updated

May 13, 2015By 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. Sordao Bernard McKenzie, LCAS-A

Title

Therapist

Phone

(336) 404-2110

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sorado McKenzie, MQMHP,MSAC,LCASA

  • Addiction (Substance Use Disorder) Counselor
  • Rockingham, NC
  • NPI 1811376965
  NPD (past)

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1306224019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S SKIPPER ST",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793843",
            "telephone_number": "336-404-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S SKIPPER ST",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793843",
            "telephone_number": "336-404-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE INTERGRATED MENTORING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "SORDAO",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "336-404-2110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCAS-A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": "2827-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 21St Century Counseling, PLLC
• A New Beginning Adult and Youth Services, Inc.
• A New Day Family Services
• A Primary Choice, Inc.
• Masoud Ahdieh, M.D.
• Katheryn Aiken
• Al H Covington OD PA
• Al H Covington OD PA
• Candy Alderman, DDS

• Early Intervention Provider Agency in Rockingham, NC
• Providers in Rockingham, NC by specialty
• Early Intervention Provider Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.