NPIMap

Organization Active NPI

National Mentor Healthcare LLC

Doing business as North Carolina Mentor

  • Psychiatry Physician
  • Laurinburg, NC
National Provider Identifier
1700103835
Registry record updated Mar 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NATIONAL MENTOR HEALTHCARE LLC
Doing business as
North Carolina Mentor
Practice address
303B S Main St
Laurinburg, NC 28352-3833
Phone
(910) 610-4494
Fax
(910) 610-4161
NPI assigned
Apr 29, 2010
Last updated
Mar 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2023

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

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

303B S Main St
Laurinburg, NC 28352-3833

Mailing address

313 Congress St
Boston, MA 02210-1218
Phone (800) 388-5150

Other names 1

  • North Carolina Mentor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
California Mentor336 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

303B S Main St
Laurinburg, NC 28352
Phone (910) 610-4494

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679184000000",
    "number": "1700103835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 CONGRESS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022101218",
            "telephone_number": "800-388-5150",
            "fax_number": "617-790-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303B S MAIN ST",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283523833",
            "telephone_number": "910-610-4494",
            "fax_number": "910-610-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2023-03-19",
        "certification_date": "2023-03-19",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Carolina Mentor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Carolina Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurinburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2023; 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.