NPIMap

Organization Active NPI

Delta Behavioral Health PLLC

  • Psychologist
  • Wilmington, NC
National Provider Identifier
1619959871
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
DELTA BEHAVIORAL HEALTH PLLC
Practice address
1606 Physicians Dr Ste 104
Wilmington, NC 28401-7348
Phone
(910) 343-6890
Fax
(910) 332-1233
NPI assigned
Nov 15, 2005
Last updated
Jul 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Authorized official

Name
Mrs. Christina Vuocolo Hall
Title
Office Manager
Phone
(910) 343-6890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

1606 Physicians Dr Ste 104
Wilmington, NC 28401-7348

Mailing address

1606 Physicians Dr Ste 104
Wilmington, NC 28401-7348
Phone (910) 343-6890

Other identifiers 2

IdentifierTypeStateIssuer
5900838MedicaidNC
6005548MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070322000168 NC Part B Supplier - Clinic/Group Practice 0143324640 Receives reassigned benefits from 11 practitioners
Practice locations: Wilmington, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2114680Delta Behavioral Health, PLLC1606 Physicians Drive, Suite 104, Wilmington, NC 28401Certificate of waiverJun 19, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1619959871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 PHYSICIANS DR STE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017348",
            "telephone_number": "910-343-6890",
            "fax_number": "910-332-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 PHYSICIANS DR STE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017348",
            "telephone_number": "910-343-6890",
            "fax_number": "910-332-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "VUOCOLO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-343-6890",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900838",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005548",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.