Port City Behavioral Health

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PORT CITY BEHAVIORAL HEALTH

Practice address

1606 Wellington Ave Ste a
Wilmington, NC 28401-7704

Phone

(910) 799-4505

Fax

(910) 799-4345

NPI assigned

Nov 1, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Charles C Creech

Title

C.E.O

Phone

(910) 799-4505

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1518211309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 WELLINGTON AVE STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017704",
            "telephone_number": "910-799-4505",
            "fax_number": "910-799-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 WELLINGTON AVE STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017704",
            "telephone_number": "910-799-4505",
            "fax_number": "910-799-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT CITY BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "CREECH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "910-799-4505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Moss Poplin, RDN, LDN
• Carson Worden Popper, DO
• Michele Mintz Populus, FNP-C
• Anna Rae Porcelli, DPT
• Kristin Porcelli, MSCCC/SLP
• Port City Chiropractic Inc.
• Port City Contracting Service
• Port City Eye Associates, OD, P.a.
• Port City Family and Cosmetic Dentistry
• Port City Medical Associates

• Mental Health Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.