Organization Active NPI

Asa Therapeutic Services, PLLC

  • Psychologist
  • Jacksonville, NC
National Provider Identifier
1366724569
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
ASA THERAPEUTIC SERVICES, PLLC
Practice address
200 Valencia Dr Ste 128
Jacksonville, NC 28546-6313
Phone
(910) 938-1300
Fax
(910) 938-2900
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Mrs. Charmaine Dowdell
Title
Executive Manager
Phone
(910) 938-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

200 Valencia Dr Ste 128
Jacksonville, NC 28546-6313

Mailing address

200 Valencia Dr Ste 128
Jacksonville, NC 28546-6313
Phone (910) 938-1300

National Provider Directory

National Provider Directory

Locations

200 Valencia Dr
Ste 128
Jacksonville, NC 28546
Phone (910) 938-1300

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1366724569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR STE 128",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466313",
            "telephone_number": "910-938-1300",
            "fax_number": "910-938-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR STE 128",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466313",
            "telephone_number": "910-938-1300",
            "fax_number": "910-938-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASA THERAPEUTIC SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "DOWDELL",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_title_or_position": "EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "910-938-1300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.