NPIMap

Organization Active NPI

Family Preservation Services of North Carolina LLC

Doing business as Clarvida

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1669507224
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY PRESERVATION SERVICES OF NORTH CAROLINA LLC
Doing business as
Clarvida
Practice address
2300 Sardis Rd N Ste M
Charlotte, NC 28227-7712
Phone
(704) 344-0491
NPI assigned
Feb 23, 2007
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Melissa Kay Hedden
Title
Contract Manager
Phone
(828) 287-7945

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Community/Behavioral Health Agency 251S00000X NU Primary
Community/Behavioral Health Agency 251S00000X NC

Addresses

Primary practice location

2300 Sardis Rd N Ste M
Charlotte, NC 28227-7712

Mailing address

PO Box 759194
Baltimore, MD 21275-9194
Phone (704) 344-0491

Other identifiers 1

IdentifierTypeStateIssuer
6005523MedicaidNC

Other names 1

  • Clarvida Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000148 NC Part B Supplier - Clinic/Group Practice 7214028539 Receives reassigned benefits from 15 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hendersonville, NC; Forest City, NC; Columbus, NC; Charlotte, NC; Asheville, NC

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory
Part of
Family Preservation Services of North Carolina Inc - Brevard Middle

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1669507224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 759194",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212759194",
            "telephone_number": "704-344-0491",
            "fax_number": "704-344-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SARDIS RD N STE M",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282277712",
            "telephone_number": "704-344-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRESERVATION SERVICES OF NORTH CAROLINA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, INC",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "HEDDEN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "828-287-7945"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005523",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.