NPIMap

Organization Active NPI

Center for Holistic Healing PC

  • Clinical Social Worker
  • High Point, NC
National Provider Identifier
1710967997
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C003439 Issued in NC
Legal business name
CENTER FOR HOLISTIC HEALING PC
Practice address
3929 Tinsley Dr Ste 104
High Point, NC 27265-1531
Phone
(336) 841-4307
Fax
(336) 841-7267
NPI assigned
Jan 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Authorized official

Name
Mr. Robert C. Goodman, LCSWNPI 1982674131
Title
President
Phone
(336) 841-4307

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 3894 NC
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X C003439 NC Primary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X 882 NC

Addresses

Primary practice location

3929 Tinsley Dr Ste 104
High Point, NC 27265-1531

Mailing address

3929 Tinsley Dr Ste 104
High Point, NC 27265-1531
Phone (336) 841-4307

Other names 1

  • The Center For Emotional Healing PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051006000968 NC Part B Supplier - Clinic/Group Practice 7911922141 Receives reassigned benefits from 10 practitioners
Practice locations: High Point, NC

National Provider Directory

National Provider Directory
Tax ID family
Center for Holistic Healing PC2 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.

Locations

1001 Phillips Ave
Ste 101
High Point, NC 27262
Phone (336) 841-4307

3929 Tinsley Dr
Ste 104
High Point, NC 27265
Phone (336) 841-3226

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1710967997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 TINSLEY DR STE 104",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272651531",
            "telephone_number": "336-841-4307",
            "fax_number": "336-841-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 TINSLEY DR STE 104",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272651531",
            "telephone_number": "336-841-4307",
            "fax_number": "336-841-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR HOLISTIC HEALING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-841-4307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3894",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003439",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center For Emotional Healing PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Center For Emotional Healing PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.