NPIMap

Organization Active NPI

Carolina Outreach, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
National Provider Identifier
1407284524
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6005418 Issued in NC
Legal business name
CAROLINA OUTREACH, LLC
Practice address
3012 Falstaff Rd
Raleigh, NC 27610-1813
Phone
(919) 615-1027
Fax
(919) 251-9008
NPI assigned
Oct 29, 2013
Last updated
Jul 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Mr. Timothy H. Brooks, MSW, LCSWNPI 1710036439
Title
Co-Director
Phone
(919) 251-9001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6005418 NC Primary

Addresses

Primary practice location

3012 Falstaff Rd
Raleigh, NC 27610-1813

Mailing address

3012 Falstaff Rd
Raleigh, NC 27610-1813
Phone (919) 615-1027

National Provider Directory

National Provider Directory
Tax ID family
Carolina Outreach LLC19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1407284524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 FALSTAFF RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101813",
            "telephone_number": "919-615-1027",
            "fax_number": "919-251-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 FALSTAFF RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101813",
            "telephone_number": "919-615-1027",
            "fax_number": "919-251-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA OUTREACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "919-251-9001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "6005418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.