The Awakening Wellness Clinic, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE AWAKENING WELLNESS CLINIC, INC

Practice address

8 Carver Rd
Jacksonville, NC 28540-7010

Phone

(910) 340-3630

Fax

(910) 597-1007

NPI assigned

Jun 26, 2020

Last updated

Jun 26, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Nicole Denice Barnes, CSACNPI 1649664152

Title

Ceo

Phone

(910) 340-3630

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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.

• Nicole Denice Barnes, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Camp Lejeune, NC
  • NPI 1649664152
  NPD Authorized official

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1710504642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CARVER RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285407010",
            "telephone_number": "910-340-3630",
            "fax_number": "910-597-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CARVER RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285407010",
            "telephone_number": "910-340-3630",
            "fax_number": "910-597-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE AWAKENING WELLNESS CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "DENICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-340-3630",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CSAC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "910-597-1007",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Healthcare exchange",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "407 N Market St",
            "city": "Washington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278894935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Substance Abuse Rehabilitation Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.