NPIMap

Organization Active NPI

Robersonville Psychosocial Rehabilitation, LLC

  • Community/Behavioral Health Agency
  • Robersonville, NC
National Provider Identifier
1700174265
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL085047 Issued in NC
Legal business name
ROBERSONVILLE PSYCHOSOCIAL REHABILITATION, LLC
Practice address
110 E Railroad St
Robersonville, NC 27871-0258
Phone
(252) 795-3311
Fax
(252) 795-3303
NPI assigned
Jul 19, 2011
Last updated
Jul 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Authorized official

Name
Mrs. Kathy Shaw Schutz, MSW LCSW LCAS CSI
Title
Ceo/President
Phone
(252) 756-5654

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL085047 NC Primary

Addresses

Primary practice location

110 E Railroad St
Robersonville, NC 27871-0258

Mailing address

702 Cromwell Dr Ste G
Greenville, NC 27858-5436
Phone (252) 745-5654

National Provider Directory

National Provider Directory
Tax ID family
Robersonville Psychosocial Rehabilitation LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1700174265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 CROMWELL DR STE G",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585436",
            "telephone_number": "252-745-5654",
            "fax_number": "252-558-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E RAILROAD ST",
            "city": "ROBERSONVILLE",
            "state": "NC",
            "postal_code": "278710258",
            "telephone_number": "252-795-3311",
            "fax_number": "252-795-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERSONVILLE PSYCHOSOCIAL REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "SCHUTZ",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "SHAW",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "252-756-5654",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW LCSW LCAS CSI"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL085047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.