NPIMap

Organization Active NPI

Allied Behavioral Healthcare, Inc.

  • Mental Health Counselor
  • Jacksonville, NC
National Provider Identifier
1609912567
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4793 Issued in NC
Legal business name
ALLIED BEHAVIORAL HEALTHCARE, INC.
Practice address
2507 N Marine Blvd
Jacksonville, NC 28546-6211
Phone
(910) 219-4100
Fax
(910) 219-4104
NPI assigned
Jan 29, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Jodi Wiley, MA
Title
Owner and Ceo
Phone
(910) 219-4100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4793 NC Primary
Mental Health Counselor 101YM0800X 3280 NC

Addresses

Primary practice location

2507 N Marine Blvd
Jacksonville, NC 28546-6211

Mailing address

2507 N Marine Blvd
Jacksonville, NC 28546-6211
Phone (910) 219-4100

Other identifiers 1

IdentifierTypeStateIssuer
8301355MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Allied Behavioral Healthcare Inc2 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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1609912567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 N MARINE BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466211",
            "telephone_number": "910-219-4100",
            "fax_number": "910-219-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 N MARINE BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466211",
            "telephone_number": "910-219-4100",
            "fax_number": "910-219-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIED BEHAVIORAL HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "OWNER AND CEO",
        "authorized_official_telephone_number": "910-219-4100",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4793",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "3280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301355",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.