Faith Springs Eternal (Fase), PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FAITH SPRINGS ETERNAL (FASE), PLLC

Practice address

910 Hope Mills Rd
Fayetteville, NC 28304-4243

Phone

(919) 888-6397

NPI assigned

Apr 1, 2020

Last updated

Jul 1, 2021By 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

Imani Nia JohnsonNPI 1073938254

Title

Owner

Phone

(678) 612-6699

Specialties & licenses 3

Addresses

Electronic endpoints 4

Interoperability endpoints

• Direct secure messaging: info@faithspringseternal.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Imani Nia Johnson, MS, MSW, LCSWA

  • Clinical Social Worker
  • Sanford, NC
  • NPI 1073938254
  NPD Authorized official

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1528696796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 HOPE MILLS RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044243",
            "telephone_number": "919-888-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 HOPE MILLS RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044243",
            "telephone_number": "919-888-6397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2537 Gray Goose Loop",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283063550",
            "country_code": "US",
            "telephone_number": "678-612-6699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAITH SPRINGS ETERNAL (FASE), PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "IMANI",
        "authorized_official_middle_name": "NIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-612-6699"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.faithspringseternal.com/",
            "affiliation": "N",
            "endpointDescription": "Organization Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "910 Hope Mills Rd",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283044243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@faithspringseternal.com",
            "affiliation": "N",
            "endpointDescription": "Organization Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "910 Hope Mills Rd",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283044243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.faithspringseternal.com/",
            "affiliation": "N",
            "endpointDescription": "Organization Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "910 Hope Mills Rd",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283044243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.faithspringseternal.com/",
            "affiliation": "N",
            "endpointDescription": "Organization Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "910 Hope Mills Rd",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283044243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Armoni Fairley, BT
• Darlene Fairley, LPC
• Mallory Deanne Fairweather, PA-C
• Jalecia Faison, PT, DPT
• Faith Over Fear LLC
• Shavone Falque, LPN
• Richard Thomas Falter Jr., M.D.
• Families 1St Counseling, PLLC
• Families for Families Service Agency
• Family Alternatives, Inc

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.