Heritage Counseling Services Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C004666 Issued in NC

Legal business name

HERITAGE COUNSELING SERVICES INC.

Practice address

2012 S Main St Ste 500D
Wake Forest, NC 27587-5008

Phone

(919) 449-0532

Fax

(919) 792-9551

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Antoine Scott, LCSW

Title

Clinical Director

Phone

(919) 449-0532

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1386677482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10835 BEDFORDTOWN DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148060",
            "telephone_number": "919-449-0532",
            "fax_number": "919-792-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 S MAIN ST STE 500D",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875008",
            "telephone_number": "919-449-0532",
            "fax_number": "919-792-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE COUNSELING SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANTOINE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "919-449-0532",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "C004666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002801",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005326",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George J Henderson, CPO
• Jolynn Hennerberg, LMFTA
• Daniel Henry, DPT
• Her Psychiatry Wellness
• Heritage Audiology, PLLC
• Heritage Eye Care, Inc
• Heritage Internal Medicine, PLLC
• Heritage Wound Management Specialists PLLC
• Guadalupe Hernandez Mancilla
• Trinity Herring

• All providers in Wake Forest, NC
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.