Triad Therapy Mental Health Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

TRIAD THERAPY MENTAL HEALTH CENTER

Practice address

315 Main St
N Wilkesboro, NC 28659-4401

Phone

(336) 990-9252

NPI assigned

Feb 21, 2008

Last updated

Sep 2, 2020By 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

Quincy Smiling, PHDNPI 1902939580

Title

President/Ceo

Phone

(336) 896-0904

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Triad Therapy Mental Health Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Triad Therapy Mental Health Center, LLC

  • Case Management Agency
  • Asheboro, NC
  • NPI 1265741417
  NPD tax ID
• Triad Therapy Mental Health Center, LLC

  • Psychiatry Physician
  • Asheboro, NC
  • NPI 1922323641
  NPD tax ID

Locations

Practitioners 3

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.

• Quincy Rochelle Smiling, PH.D., LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Winston Salem, NC
  • NPI 1902939580
  Authorized official Same address or phone
• Justina Anulika Okonkwo, DNP, PMHNP-BC, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • High Point, NC
  • NPI 1194228205
  NPD
• Helen Barr Vickers, FNP

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1457439036
  NPD

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1588833701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N COX ST STE 16",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035514",
            "telephone_number": "336-629-7774",
            "fax_number": "336-629-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MAIN ST",
            "city": "N WILKESBORO",
            "state": "NC",
            "postal_code": "286594401",
            "telephone_number": "336-990-9252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7830 N Point Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063261",
            "country_code": "US",
            "telephone_number": "336-896-0904",
            "fax_number": "336-896-1402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2720 Georgetown Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271065473",
            "country_code": "US",
            "telephone_number": "336-529-6300",
            "fax_number": "336-529-6307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "172 W Independence Blvd",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "NC",
            "postal_code": "270303566",
            "country_code": "US",
            "telephone_number": "336-648-8585",
            "fax_number": "336-648-8588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131B Davis St",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272035470",
            "country_code": "US",
            "telephone_number": "336-629-7774",
            "fax_number": "336-629-7776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRIAD THERAPY MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "SMILING",
        "authorized_official_first_name": "QUINCY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "336-896-0904",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641001",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Office",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7830 N Point Blvd Ste 201",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271063261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in N Wilkesboro, NC
• Providers in N Wilkesboro, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.