NPIMap

Organization Active NPI

Supportone Inc

Doing business as Community-Based Services, Inc.

  • Mental Health Counselor
  • Richmond, VA
National Provider Identifier
1629001896
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
323 Issued in VA
Legal business name
SUPPORTONE INC
Doing business as
Community-Based Services, Inc.
Practice address
3500 Kensington Ave Ste B
Richmond, VA 23221-2144
Phone
(804) 342-7366
Fax
(804) 342-7368
NPI assigned
Jul 9, 2006
Last updated
Aug 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Authorized official

Name
Mrs. Cassandra Pettus Scarborough, CPA
Title
Executive Director
Phone
(804) 340-1845

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 323-01-0001 VA
Mental Health Counselor 101YM0800X 323 VA Primary

Addresses

Primary practice location

3500 Kensington Ave Ste B
Richmond, VA 23221-2144

Mailing address

2100 W Labumum Ave
Suite 104-B
Richmond, VA 23227
Phone (804) 340-1845

Other identifiers 1

IdentifierTypeStateIssuer
004948271MedicaidVA

Other names 1

  • Community-Based Services, Inc. Doing business as

National Provider Directory

National Provider Directory

Locations

2100 W Laburnum Ave
Ste 104B
Richmond, VA 23227

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1629001896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W LABUMUM AVE",
            "address_2": "SUITE 104-B",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23227",
            "telephone_number": "804-340-1845",
            "fax_number": "804-340-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 KENSINGTON AVE STE B",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232212144",
            "telephone_number": "804-342-7366",
            "fax_number": "804-342-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTONE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "SCARBOROUGH",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "PETTUS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-340-1845",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "323-01-0001",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004948271",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community-Based Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; 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.