NPIMap

Organization Active NPI

Kingspointe Behavioral Healthcare Services, LLC

  • Community/Behavioral Health Agency
  • Shelby, NC
National Provider Identifier
1477692242
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KINGSPOINTE BEHAVIORAL HEALTHCARE SERVICES, LLC
Practice address
201 W Marion St
Suite 207
Shelby, NC 28150-5091
Phone
(704) 487-6226
Fax
(704) 487-6286
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Mr. Llrae Scott, B.S., QMHP
Title
Executivedirectorclinicalservices
Phone
(704) 487-6226

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 2260 NC
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 5595 NC
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-023-046 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-023-128 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-055-090 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-055-091 NC

Addresses

Primary practice location

201 W Marion St
Suite 207
Shelby, NC 28150-5091

Mailing address

201 W Marion St
Suite 207
Shelby, NC 28150-5091
Phone (704) 487-6226

Other identifiers 10

IdentifierTypeStateIssuer
3418018MedicaidNC
6603802MedicaidNC
8300864MedicaidNC
8300864GMedicaidNC
6604075MedicaidNC
6603801MedicaidNC
8300864BMedicaidNC
6005943MedicaidNC
6604071MedicaidNC
8300864HMedicaidNC

Other names 1

  • Kingspointe Academy, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

201 W Marion St
Ste 207
Shelby, NC 28150
Phone (704) 487-6226

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1477692242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W MARION ST",
            "address_2": "SUITE 207",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281505091",
            "telephone_number": "704-487-6226",
            "fax_number": "704-487-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W MARION ST",
            "address_2": "SUITE 207",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281505091",
            "telephone_number": "704-487-6226",
            "fax_number": "704-487-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSPOINTE BEHAVIORAL HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "LLRAE",
        "authorized_official_title_or_position": "EXECUTIVEDIRECTORCLINICALSERVICES",
        "authorized_official_telephone_number": "704-487-6226",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S., QMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2260",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5595",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-023-046",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-023-128",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-055-090",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-055-091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418018",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603802",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300864",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300864G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604075",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603801",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300864B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005943",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604071",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300864H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingspointe Academy, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.