NPIMap

Organization Active NPI

Wilson Greene Mental Health

  • Mental Health Counselor
  • Wilson, NC
National Provider Identifier
1417017963
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WILSON GREENE MENTAL HEALTH
Practice address
1709 Tarboro St SW
Wilson, NC 27893-3428
Phone
(252) 399-8021
NPI assigned
Dec 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy Rackley
Title
Finance Officer
Phone
(252) 937-8141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1709 Tarboro St SW
Wilson, NC 27893-3428

Mailing address

1709 Tarboro St SW
Wilson, NC 27893-3428
Phone (252) 399-8021

Other identifiers 8

IdentifierTypeStateIssuer
07196OtherNCBLUE CROSS
3408391MedicaidNC
5901818OtherNCPHYSICIAN GROUP NUMBER
3404936OtherNCBILLING PROVIDER NUMBER
8301342MedicaidNC
5901738MedicaidNC
8301342GMedicaidNC
6005615OtherNCMULTI-SPECIALTY NUMBER

National Provider Directory

National Provider Directory

Locations

1709 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8021

Practitioners & affiliated clinicians

Practitioners 11

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417017963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-399-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-399-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON GREENE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RACKLEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "252-937-8141"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "07196",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408391",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN GROUP NUMBER",
            "identifier": "5901818",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BILLING PROVIDER NUMBER",
            "identifier": "3404936",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301342",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901738",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301342G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI-SPECIALTY NUMBER",
            "identifier": "6005615",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.