NPIMap

Organization Active NPI

Lutheran Family Services in the Carolinas

  • Community/Behavioral Health Agency
  • Clemmons, NC
National Provider Identifier
1578619938
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LUTHERAN FAMILY SERVICES IN THE CAROLINAS
Practice address
6590 Rollingwood Dr
Clemmons, NC 27012-9119
Phone
(336) 766-9833
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Authorized official

Name
Kirby Nickerson
Title
Cfo
Phone
(704) 637-2870

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL034174

Addresses

Primary practice location

6590 Rollingwood Dr
Clemmons, NC 27012-9119

Mailing address

PO Box 2369
Salisbury, NC 28145
Phone (704) 637-2870

Other identifiers 3

IdentifierTypeStateIssuer
8301054MedicaidNC
7804965MedicaidNC
8301054BMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Counseling Cen29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498435200000",
    "number": "1578619938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2369",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28145",
            "telephone_number": "704-637-2870",
            "fax_number": "704-637-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6590 ROLLINGWOOD DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129119",
            "telephone_number": "336-766-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN FAMILY SERVICES IN THE CAROLINAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-06-26",
        "status": "A",
        "authorized_official_last_name": "NICKERSON",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-637-2870"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": "MHL034174",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301054",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804965",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301054B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; 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.