NPIMap

Organization Active NPI

A Fresh Start Behavioral Health Services, PLLC

  • Clinical Social Worker
  • New Bern, NC
National Provider Identifier
1710499223
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008809 Issued in NC
Legal business name
A FRESH START BEHAVIORAL HEALTH SERVICES, PLLC
Practice address
2407 Grace Ave
New Bern, NC 28562-4416
Phone
(252) 414-9776
Fax
(252) 414-9776
NPI assigned
Oct 25, 2017
Last updated
Jan 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Authorized official

Name
Anthony Lamont Harris, MSW, LCSW, LCASANPI 1902283633
Title
Owner/Manager
Phone
(252) 414-9776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C008809 NC Primary

Addresses

Primary practice location

2407 Grace Ave
New Bern, NC 28562-4416

Mailing address

PO Box 1992
Greenville, NC 27835-1992

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180117002275 NC Part B Supplier - Clinic/Group Practice 9931466646 Receives reassigned benefits from 11 practitioners
Practice locations: Greenville, NC; New Bern, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1710499223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1992",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278351992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 GRACE AVE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285624416",
            "telephone_number": "252-414-9776",
            "fax_number": "252-414-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FRESH START BEHAVIORAL HEALTH SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "LAMONT",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "252-414-9776",
        "authorized_official_credential": "MSW, LCSW, LCASA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.