NPIMap

Organization Active NPI

Superior Healthcare Services

  • Clinical Psychologist
  • Wadesboro, NC
National Provider Identifier
1609088897
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SUPERIOR HEALTHCARE SERVICES
Practice address
913 E. Casswell St
Wadesboro, NC 28170
Phone
(704) 694-9135
Fax
(704) 694-3011
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Authorized official

Name
Mr. Jason Christopher Jones
Title
Ceo
Phone
(704) 361-2765

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

913 E. Casswell St
Wadesboro, NC 28170

Mailing address

P.O Box 690547
Charlotte, NC 28227
Phone (704) 563-6262

Other identifiers 1

IdentifierTypeStateIssuer
6005991MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Superior Healthcare Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264464000000",
    "number": "1609088897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 690547",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28227",
            "telephone_number": "704-563-6262",
            "fax_number": "704-563-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 E. CASSWELL ST",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "28170",
            "telephone_number": "704-694-9135",
            "fax_number": "704-694-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-01-26",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-361-2765",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005991",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.