NPIMap

Organization Active NPI

Wilmington Health Access for Teens, Inc

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1396188207
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WILMINGTON HEALTH ACCESS FOR TEENS, INC
Doing business as
Ashley High School Wellness Center-BH
Practice address
555 Halyburton Memorial Pkwy
Wilmington, NC 28412-3094
Phone
(910) 452-6320
Fax
(910) 790-4166
NPI assigned
Apr 10, 2013
Organization subpart
Yes
Parent organization
WILMINGTON HEALTH ACCESS FOR TEENS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Authorized official

Name
Maria Van de Bovenkamp
Title
Director of Administration
Phone
(910) 790-9949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

555 Halyburton Memorial Pkwy
Wilmington, NC 28412-3094

Mailing address

4005 Oleander Dr
Wilmington, NC 28403-6816
Phone (910) 790-9949

Other names 1

  • Ashley High School Wellness Center-BH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wilmington Health Access for Teens7 organizations share this tax ID, including this one
Part of
Wilmington Health Access for Teens

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1396188207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036816",
            "telephone_number": "910-790-9949",
            "fax_number": "910-790-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 HALYBURTON MEMORIAL PKWY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123094",
            "telephone_number": "910-452-6320",
            "fax_number": "910-790-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON HEALTH ACCESS FOR TEENS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILMINGTON HEALTH ACCESS FOR TEENS, INC",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "VAN DE BOVENKAMP",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "910-790-9949"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashley High School Wellness Center-BH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.