Prestige Childrens Trauma Child Development Corp

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

PRESTIGE CHILDRENS TRAUMA CHILD DEVELOPMENT CORP

Doing business as

PRESTIGE CHILDRENS TRAUMA CDC

Practice address

3030 Glen Laurel Dr
Concord, NC 28025-1614

Phone

(980) 219-0907

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Wanda Marie BurnsNPI 1528769163

Title

Pastoral Counselor

Phone

(888) 779-1232

Specialties & licenses 7

Addresses

Other names 1

• PRESTIGE CHILDRENS TRAUMA CDC Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Wanda Marie Burns

  • Behavior Technician
  • Mooresville, NC
  • NPI 1528769163

  Pastoral

  NPD (past) Authorized official

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

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    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1427764836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 UNION ST S STE 1221",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255009",
            "telephone_number": "980-292-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 GLEN LAUREL DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251614",
            "telephone_number": "980-219-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE CHILDRENS TRAUMA CHILD DEVELOPMENT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PASTORAL COUNSELOR",
        "authorized_official_telephone_number": "888-779-1232",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DR.BURNS@PRESTIGECDC.COM",
            "affiliation": "N",
            "endpointDescription": "RECORDS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "57 Union St S Ste 1221",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280255009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PRESTIGE CHILDRENS TRAUMA CDC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chely Pressley, DDS
• Justin Pressley, PHARMD
• Laura Pressley
• Marla Presta-Carnes, MD
• Monica Jo Prestage, LCSW & CSAC-I
• Shannon Price-Scanlon
• Eric Paul Price, DPT
• Samantha Price, FNP-C
• Shunta Robinson Price, LCAS
• Elizabeth Hyde Prichard, MD

• Behavior Analyst in Concord, NC
• Providers in Concord, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.