Active NPI
A Fresh Start Behavioral Health Services, PLLC
- Clinical Social Worker
- New Bern, NC
National Provider Identifier
1710499223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C008809
- 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
- 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
- Anthony Lamont Harris, MSW, LCSW, LCASA
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
3491 Evans St
Ste A
Greenville, NC 27834
Phone (252) 341-0078
2407 Grace Ave
Trent Woods, NC 28562
Phone (252) 514-7766
Practitioners & affiliated clinicians
Practitioners 23
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Jacksonville, NC
- NPI 1508121336
NC
-
- Mental Health Counselor
- New Bern, NC
- NPI 1194134619
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.