NPIMap

Organization Active NPI

Advantage Behavioral Healthcare Inc.

  • Mental Health Counselor
  • Whiteville, NC
National Provider Identifier
1689750663
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ADVANTAGE BEHAVIORAL HEALTHCARE INC.
Practice address
732 Davis Avenue
Whiteville, NC 28472-6002
Phone
(910) 640-1038
Fax
(910) 640-1465
NPI assigned
Oct 31, 2006
Last updated
Jan 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Authorized official

Name
Mr. Kenneth Clyde Hunt
Title
Ceo
Phone
(910) 640-1038

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Counselor 101Y00000X
Mental Health Counselor 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

732 Davis Avenue
Whiteville, NC 28472-6002

Mailing address

PO Box 1383
Whiteville, NC 28472-1383
Phone (910) 640-1038

Other identifiers 19

IdentifierTypeStateIssuer
5906566MedicaidNC
8301619HMedicaidNC
3418282MedicaidNC
5968204MedicaidNC
6005978MedicaidNC
8302582RMedicaidNC
8303167RMedicaidNC
8303168MedicaidNC
8301619MedicaidNC
8302158-BMedicaidNC
8302158-GMedicaidNC
8302158-HMedicaidNC
8303167MedicaidNC
8303168RMedicaidNC
8302158MedicaidNC
8302629GMedicaidNC
3418242MedicaidNC
8301619BMedicaidNC
8702269MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101222000938 NC Part B Supplier - Clinic/Group Practice 3779771316 Receives reassigned benefits from 10 practitioners
Practice locations: Lumberton, NC; Pembroke, NC; Whiteville, NC

National Provider Directory

National Provider Directory

Locations

405 Biggs St
Laurinburg, NC 28352
Phone (910) 610-4444

1600 E 5th St
Lumberton, NC 28358
Phone (910) 640-1038

609 Harry West Ln
Pembroke, NC 28372
Phone (910) 521-7288

732 Davis Ave
Whiteville, NC 28472
Phone (910) 632-4633

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1689750663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1383",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284721383",
            "telephone_number": "910-640-1038",
            "fax_number": "910-640-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 DAVIS AVENUE",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284726002",
            "telephone_number": "910-640-1038",
            "fax_number": "910-640-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE BEHAVIORAL HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-640-1038",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
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            "identifier": "5906566",
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        },
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            "identifier": "6005978",
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        },
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            "identifier": "8302582R",
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        },
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        },
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            "code": "05",
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            "identifier": "8302158-B",
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            "code": "05",
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            "identifier": "8302158-G",
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            "code": "05",
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            "code": "05",
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            "issuer": null,
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            "identifier": "8702269",
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    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.