Mlphenrydba Developmental Therapy Services

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

License

CBRS INFANT TODDLER Issued in NC

Legal business name

MLPHENRYDBA DEVELOPMENTAL THERAPY SERVICES

Practice address

7125 Bass Mountain Rd
Snow Camp, NC 27349-9167

Phone

(336) 214-2879

NPI assigned

Sep 30, 2013

Last updated

Oct 16, 2013By 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

Mrs. Margaret Lisa Pike Henry

Title

CBRS Provider

Phone

(336) 214-2879

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1457788929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 BASS MOUNTAIN RD",
            "city": "SNOW CAMP",
            "state": "NC",
            "postal_code": "273499167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 BASS MOUNTAIN RD",
            "city": "SNOW CAMP",
            "state": "NC",
            "postal_code": "273499167",
            "telephone_number": "336-214-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLPHENRYDBA DEVELOPMENTAL THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "MARGARET LISA",
        "authorized_official_middle_name": "PIKE",
        "authorized_official_title_or_position": "CBRS PROVIDER",
        "authorized_official_telephone_number": "336-214-2879",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NC",
            "license": "CBRS INFANT TODDLER",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300168",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- INDIVIDUAL",
            "identifier": "1417091034",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300168K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reina Galjour, CPM, LM
• Jamie Lin Hall
• Laboratory Corporation of America Holdings
• Kaitlin C Lenhart, PHD, FACMG
• Brittany Alexis Miller, LCSWA
• Piedmont Health Services, Inc. (Sylvan Community Health Center)
• Elizabeth Suzanne Pointer, NP
• Leslie McDonough Sharpe, N.P.
• Mary McClellan Sutton, LPN, CST,CFA,,SA
• Robin A Whitten, P.A.

• Supports Brokerage Agency in Snow Camp, NC
• Providers in Snow Camp, NC by specialty
• Supports Brokerage Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.