NPIMap

Organization Active NPI

Behavioral Health Services of Lake Norman

  • Professional Counselor
  • Mooresville, NC
National Provider Identifier
1619331113
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2215 Issued in NC
Legal business name
BEHAVIORAL HEALTH SERVICES OF LAKE NORMAN
Practice address
107 Kilson Dr
Suite 202
Mooresville, NC 28117-8162
Phone
(704) 660-8321
Fax
(704) 660-8323
NPI assigned
Apr 11, 2016
Last updated
Apr 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Authorized official

Name
Michael E RifeNPI 1275519068
Title
Owner
Phone
(704) 660-8321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2215 NC Primary

Addresses

Primary practice location

107 Kilson Dr
Suite 202
Mooresville, NC 28117-8162

Mailing address

107 Kilson Dr
Suite 202
Mooresville, NC 28117-8162
Phone (704) 660-8321

Other identifiers 1

IdentifierTypeStateIssuer
6103394MedicaidNC

National Provider Directory

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": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1619331113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 KILSON DR",
            "address_2": "SUITE 202",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178162",
            "telephone_number": "704-660-8321",
            "fax_number": "704-660-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 KILSON DR",
            "address_2": "SUITE 202",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178162",
            "telephone_number": "704-660-8321",
            "fax_number": "704-660-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH SERVICES OF LAKE NORMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "RIFE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-660-8321"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103394",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.