NPIMap

Organization Active NPI

Family Service of the Piedmont

  • Mental Health Counselor
  • Jamestown, NC
National Provider Identifier
1619150265
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAMILY SERVICE OF THE PIEDMONT
Practice address
902 Bonner Dr
Jamestown, NC 27282-8948
Phone
(336) 889-6105
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Thomas Bonney, ACSW, LCSW
Title
President and Ceo
Phone
(336) 478-2017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

902 Bonner Dr
Jamestown, NC 27282-8948

Mailing address

902 Bonner Dr
Jamestown, NC 27282-8948

Other identifiers 1

IdentifierTypeStateIssuer
8301199 HMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Family Service of the Piedmont Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1619150265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BONNER DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 BONNER DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828948",
            "telephone_number": "336-889-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE OF THE PIEDMONT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "BONNEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "336-478-2017",
        "authorized_official_credential": "ACSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301199 H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.