NPIMap

Organization Active NPI

Living Well Behavioral Health Lab

  • Clinical Medical Laboratory
  • Fayetteville, NC
National Provider Identifier
1619349107
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LIVING WELL BEHAVIORAL HEALTH LAB
Practice address
2350 Bentridge LN Ste 301a
Fayetteville, NC 28304-0590
Phone
(910) 748-0261
Fax
(910) 758-9358
NPI assigned
Oct 23, 2015
Last updated
Oct 29, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
LIVING WELL BEHAVIORAL HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Authorized official

Name
Patricia Deleuran
Title
President
Phone
(919) 803-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2350 Bentridge LN Ste 301a
Fayetteville, NC 28304-0590

Mailing address

2350 Bentridge LN Ste 301a
Fayetteville, NC 28304-0590
Phone (910) 748-0261

National Provider Directory

National Provider Directory
Tax ID family
Living Well Behavioral Health Inc5 organizations share this tax ID, including this one
Part of
Living Well Behavioral Health Inc

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1619349107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 BENTRIDGE LN STE 301A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040590",
            "telephone_number": "910-748-0261",
            "fax_number": "910-758-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 BENTRIDGE LN STE 301A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040590",
            "telephone_number": "910-748-0261",
            "fax_number": "910-758-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL BEHAVIORAL HEALTH LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVING WELL BEHAVIORAL HEALTH, INC.",
        "enumeration_date": "2015-10-23",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "DELEURAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-803-2111"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.