NC Mentor

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

P006264 Issued in NC

Legal business name

NC MENTOR

Practice address

3125 Poplarwood Court
Suite 300
Raleigh, NC 27604

Phone

(919) 345-8012

NPI assigned

May 9, 2012

Last updated

May 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Latwana Oliver, PLCSWNPI 1518214162

Title

Family Support Specialist

Phone

(919) 345-8012

Specialties & licenses 1

Addresses

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.

• Latwana Oliver, LCSWA

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1518214162
  Authorized official Same address or phone

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1427317619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD COURT",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27604",
            "telephone_number": "919-345-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NC MENTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "LATWANA",
        "authorized_official_title_or_position": "FAMILY SUPPORT SPECIALIST",
        "authorized_official_telephone_number": "919-345-8012",
        "authorized_official_credential": "PLCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "P006264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NC Dept of Health and Human Service (North Carolina State Laboratory of Public Health)
• NC Dept of Health and Human Service/DVRS (NC Assistive Technology Program)
• NC DHHS Child and Family Well-Being
• NC Doctors of Optometry PLLC (Visionworks N.C. Doctors of Optometry, PLLC)
• NC Family Care LLC
• NC Ocme
• NC Physiatry PLLC
• NC Physical Therapy and Balance LLC (FYZICAL Therapy & Balance Centers)
• NC Preventative Medicine and Wellness Clinic
• NC Recovery Support Services

• Community/Behavioral Health Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.