Carolina Professional Mental Health

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

261QM0801X Issued in NC

Legal business name

CAROLINA PROFESSIONAL MENTAL HEALTH

Practice address

109 N Court SQ
Lumberton, NC 28358-5554

Phone

(910) 272-9356

Fax

(910) 735-1945

NPI assigned

Feb 12, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Frederick Hodge Stephens, PLCSW

Title

Coowner

Phone

(910) 272-9356

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Carolina Professional Mental Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Carolina Professional Mental Health Associates, Inc.

  • Mental Health Counselor
  • Lumberton, NC
  • NPI 1194888016
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dawn L. Bass, BSW MA LPC NBCC

  • Professional Counselor
  • Lumberton, NC
  • NPI 1265661201
  NPD (past)

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1396984480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N COURT SQ",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283585554",
            "telephone_number": "910-272-9356",
            "fax_number": "910-735-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N COURT SQ",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283585554",
            "telephone_number": "910-272-9356",
            "fax_number": "910-735-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PROFESSIONAL MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "HODGE",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "910-272-9356",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PLCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "261QM0801X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SR001844",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Eye Care Professionals,PA
• Carolina Family and Urgent Care
• Carolina Health Services
• Carolina Infectious Diseases Consultants PC
• Carolina Professional Medical Supplies
• Carolina Professional Mental Health Associates, Inc.
• Carolina Respicare Pharmacy,Inc
• Carolina Urology PA
• Alesia Renee Carr, LPC-A
• Zachary Joseph Carriker, MD

• All providers in Lumberton, NC
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.