NPIMap

Organization Active NPI

Vision Behavioral Health Services, LLC

  • Community/Behavioral Health Agency
  • Louisburg, NC
National Provider Identifier
1619268109
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VISION BEHAVIORAL HEALTH SERVICES, LLC
Practice address
104 N Main St
Suite a
Louisburg, NC 27549-2516
Phone
(919) 496-7781
Fax
(919) 496-1477
NPI assigned
May 2, 2011
Last updated
Dec 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Mrs. Nicole Decarlo Spruill, MSW LCSW RYT200
Title
Ceo
Phone
(919) 496-7781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

104 N Main St
Suite a
Louisburg, NC 27549-2516

Mailing address

104 N Main St
Suite 1
Louisburg, NC 27549-2516
Phone (919) 496-7787

Other identifiers 1

IdentifierTypeStateIssuer
6006273MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Vision Behavioral Health Services13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

104 N Main St
Ste 1
Louisburg, NC 27549

104 N Main St
Ste A
Louisburg, NC 27549
Phone (919) 496-7781

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1619268109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N MAIN ST",
            "address_2": "SUITE 1",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492516",
            "telephone_number": "919-496-7787",
            "fax_number": "919-496-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N MAIN ST",
            "address_2": "SUITE A",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492516",
            "telephone_number": "919-496-7781",
            "fax_number": "919-496-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "SPRUILL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "DECARLO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-496-7781",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW LCSW RYT200"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006273",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.