NPIMap

Organization Active NPI

Program Resource Institute

  • Addiction (Substance Use Disorder) Counselor
  • Sanford, NC
National Provider Identifier
1497942155
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
MHL-053-026 Issued in NC
Legal business name
PROGRAM RESOURCE INSTITUTE
Practice address
2509 Fayetteville St
Sanford, NC 27330
Phone
(919) 774-7746
Fax
(919) 775-2779
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Mr. Theodore Fitzgerald
Title
Executive Director
Phone
(910) 891-7062

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X MHL-053-026 NC
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X MHL-053-026 NC Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X MHL-053-026 NC

Addresses

Primary practice location

2509 Fayetteville St
Sanford, NC 27330

Mailing address

108 N Orange Ave
Dunn, NC 28334-3826
Phone (910) 891-7062

National Provider Directory

National Provider Directory
Tax ID family
Program Resource Institute5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

108 N Orange Ave
Dunn, NC 28334
Phone (910) 891-7062

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1497942155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N ORANGE AVE",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283343826",
            "telephone_number": "910-891-7062",
            "fax_number": "910-892-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 FAYETTEVILLE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "27330",
            "telephone_number": "919-774-7746",
            "fax_number": "919-775-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRAM RESOURCE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-891-7062",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NC",
            "license": "MHL-053-026",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "MHL-053-026",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "MHL-053-026",
            "primary": false
        }
    ],
    "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 Oct 17, 2007; 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.