Active NPI
Professional Family Care Services, Inc
- Clinical Social Worker
- Fayetteville, NC
National Provider Identifier
1679799183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- PROFESSIONAL FAMILY CARE SERVICES, INC
- Practice address
- 811 Stamper Rd Unit 4-5
Fayetteville, NC 28303-4215 - Phone
- (910) 485-0085
- NPI assigned
- Apr 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Benson Otovo, MBA
- Title
- Executive Director
- Phone
- (910) 485-0085
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
811 Stamper Rd Unit 4-5
Fayetteville, NC 28303-4215
Mailing address
PO Box 35150
Fayetteville, NC 28303-0150
Phone (910) 485-0085
Other practice location 1
4441 Bragg Blvd Ste 114
Fayetteville, NC 28303
Phone (910) 485-0085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6006010 | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
4441 Bragg Blvd
Ste 114
Fayetteville, NC 28303
Phone (910) 485-0085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1671408000000",
"number": "1679799183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35150",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283030150",
"telephone_number": "910-485-0085",
"fax_number": "910-485-0334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 STAMPER RD UNIT 4-5",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283034215",
"telephone_number": "910-485-0085"
}
],
"practiceLocations": [
{
"address_1": "4441 Bragg Blvd Ste 114",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "28303",
"country_code": "US",
"telephone_number": "910-485-0085",
"fax_number": "910-630-2278",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PROFESSIONAL FAMILY CARE SERVICES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-17",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A",
"authorized_official_last_name": "OTOVO",
"authorized_official_first_name": "BENSON",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "910-485-0085",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6006010",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
- Professional Early Intervention Services, LLC
- Professional Early Intervention Services, LLC
- Professional Eyecare Optometry PA
- Professional Family Care Services, Inc
- Professional Family Care Services, Inc
- Professional Family Care Services, Inc.
- Professional Family Care Services, Inc.
- Professional Family Care Services, Inc.
- Professional Healthcare, LLC
- Professional Home Care of NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.