Physician Alliance for Mental Health

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PHYSICIAN ALLIANCE FOR MENTAL HEALTH

Practice address

4130 Oleander Drive
Suite 100
Wilmington, NC 28403-4423

Phone

(910) 794-3929

Fax

(910) 798-2303

NPI assigned

Jan 24, 2011

Organization subpart

No

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

Authorized official

Name

Wendy Rene' Kaczynski

Title

Provider Manager

Phone

(910) 262-7107

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Physician Alliance for Mental Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Physician Alliance for Mental Health LLC

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1942505987
  NPD tax ID

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1578868436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DRIVE",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034423",
            "telephone_number": "910-794-3929",
            "fax_number": "910-798-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DRIVE",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034423",
            "telephone_number": "910-794-3929",
            "fax_number": "910-798-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ALLIANCE FOR MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "KACZYNSKI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "RENE'",
        "authorized_official_title_or_position": "PROVIDER MANAGER",
        "authorized_official_telephone_number": "910-262-7107"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8703155",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phyllis Coulter Everett
• Physical Therapy for Life
• Physical Therapy for Women, Inc
• Physical Therapy Services of Wilmington
• Physical Therapy Services of Wilmington at Porter'S Neck, LLC
• Physician Alliance for Mental Health LLC
• Physician Alliance for Mental Health, LLC
• Physician Alliance of Mental Health
• Physicians Choice Medical Equipment
• Panida Piboolnurak, MD

• Case Management Agency in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.