Active NPI
C-Blac Services, Inc.
- Addiction (Substance Use Disorder) Counselor
- Smithfield, NC
National Provider Identifier
1609956630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- MHL 051-128
- Legal business name
- C-BLAC SERVICES, INC.
- Practice address
- 1302 W Market St
Smithfield, NC 27577-3339 - Phone
- (919) 989-1786
- Fax
- (919) 989-1791
- NPI assigned
- Oct 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Janet M Wise, MSW, CSAC, LCAS
- Title
- Ceo
- Phone
- (919) 989-1786
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MHL 051-128 | NC | Primary |
| Mental Health Counselor | 101YM0800X | MHL 051-128 | NC | |
| Addiction Psychiatry Physician | 2084P0802X | MHL 051-128 | NC | |
| Case Management Agency | 251B00000X | MHL 051-128 | NC | |
| Home Health Agency | 251E00000X | MHL 051-128 | NC | |
| Public Health or Welfare Agency | 251K00000X | MHL 051-128 | NC | |
| Community/Behavioral Health Agency | 251S00000X | MHL 051-128 | NC | |
| Multi-Specialty Clinic/Center | 261QM1300X | MHL 051-128 | NC |
Addresses
Primary practice location
1302 W Market St
Smithfield, NC 27577-3339
Mailing address
PO Box 1629
Smithfield, NC 27577-1629
Phone (919) 989-1786
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MHL 051-128 | Other | NC | MENTAL HEALTH LICENSE |
National Provider Directory
National Provider Directory- Tax ID family
- C-Blac Services Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Smithfield, NC
- NPI 1184761660
Locations
1302 W Market St
Smithfield, NC 27577
Phone (919) 989-1786
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Smithfield, NC
- NPI 1700966611
Addiction (Substance Use Disorder)
-
- Addiction (Substance Use Disorder) Counselor
- Smithfield, NC
- NPI 1326187568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211241600000",
"number": "1609956630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1629",
"city": "SMITHFIELD",
"state": "NC",
"postal_code": "275771629",
"telephone_number": "919-989-1786",
"fax_number": "919-989-1791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1302 W MARKET ST",
"city": "SMITHFIELD",
"state": "NC",
"postal_code": "275773339",
"telephone_number": "919-989-1786",
"fax_number": "919-989-1791"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "C-BLAC SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-16",
"last_updated": "2008-05-20",
"status": "A",
"authorized_official_last_name": "WISE",
"authorized_official_first_name": "JANET",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "919-989-1786",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MSW, CSAC, LCAS"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "MHL 051-128",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "MHL 051-128",
"primary": false
},
{
"code": "2084P0802X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "NC",
"license": "MHL 051-128",
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "NC",
"license": "MHL 051-128",
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NC",
"license": "MHL 051-128",
"primary": false
},
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "NC",
"license": "MHL 051-128",
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NC",
"license": "MHL 051-128",
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "NC",
"license": "MHL 051-128",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH LICENSE",
"identifier": "MHL 051-128",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Smithfield, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.