NPIMap

Organization Active NPI

Family Preservation Services of NC, Inc - Sanford Opt

  • Community/Behavioral Health Agency
  • Sanford, NC
National Provider Identifier
1497183230
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY PRESERVATION SERVICES OF NC, INC - SANFORD OPT
Practice address
329 Carthage St
Sanford, NC 27330-4206
Phone
(704) 344-0491
NPI assigned
Oct 14, 2013
Last updated
Sep 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Authorized official

Name
Miranda Little
Title
NC Qi & Training Director
Phone
(704) 344-0491

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Psychologist 103T00000X
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Psychologist 103TC0700X
Counseling Psychologist 103TC1900X
Clinical Child & Adolescent Psychologist 103TC2200X
Social Worker 104100000X
Clinical Social Worker 1041C0700X
School Social Worker 1041S0200X
Marriage & Family Therapist 106H00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

329 Carthage St
Sanford, NC 27330-4206

Mailing address

PO Box 759194
Baltimore, MD 21275-9194
Phone (704) 344-0491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000148 NC Part B Supplier - Clinic/Group Practice 7214028539 Receives reassigned benefits from 15 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hendersonville, NC; Forest City, NC; Columbus, NC; Charlotte, NC; Asheville, NC

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory

Locations

2300 Sardis Rd N
Ste M
Charlotte, NC 28227
Phone (828) 254-5008

329 Carthage St
Sanford, NC 27330
Phone (919) 718-1355

NPI Registry JSON

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1497183230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 759194",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212759194",
            "telephone_number": "704-344-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304206",
            "telephone_number": "704-344-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRESERVATION SERVICES OF NC, INC - SANFORD OPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "NC QI & TRAINING DIRECTOR",
        "authorized_official_telephone_number": "704-344-0491"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.