Family Behavioral Health Services, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FAMILY BEHAVIORAL HEALTH SERVICES, INC

Practice address

1528 Union Rd
Gastonia, NC 28054-2200

Phone

(704) 995-4724

Fax

(704) 864-1476

NPI assigned

May 31, 2017

Last updated

Jul 21, 2022By 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

Holly Shivadecker

Title

Ceo

Phone

(704) 995-4724

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1427586700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 UNION RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542200",
            "telephone_number": "704-995-4724",
            "fax_number": "704-864-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 UNION RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542200",
            "telephone_number": "704-995-4724",
            "fax_number": "704-864-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY BEHAVIORAL HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHIVADECKER",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-995-4724"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.