Prosource Therapeutics, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

PROSOURCE THERAPEUTICS, LLC

Practice address

201 E Pitt St
Tarboro, NC 27886-5192

Phone

(252) 353-7025

NPI assigned

Jan 8, 2009

Organization subpart

No

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

Authorized official

Name

Felicia Smith

Title

Administrator

Phone

(252) 353-7025

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Prosource Therapeutics LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Prosource Therapeutics

  • Clinical Social Worker
  • New Bern, NC
  • NPI 1659530145
  NPD tax ID
• Prosource Therapeutics, LLC

  • Clinical Social Worker
  • Robersonville, NC
  • NPI 1578799664
  NPD tax ID
• Prosource Therapeutics, LLC

  • Clinical Social Worker
  • Williamston, NC
  • NPI 1811158546
  NPD tax ID

Locations

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1720225014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 FOX HAVEN DR STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278589720",
            "telephone_number": "252-353-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E PITT ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278865192",
            "telephone_number": "252-353-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSOURCE THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "252-353-7025"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BLUE CROSS BLUE SHIELD",
            "identifier": "017PN",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005734",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Positive Steps Residential Service, Inc
• Edward Tremayne Powell
• Jerry W. Price, D.D.S.
• Jennifer Leigh Pridgen, PTA
• Ashley Nicole Privett, COTA/L
• Meredith Purser, COTA/L
• Reaching Your Goals
• Recovery Journey Services LLC
• April Reichmeider, R.D.
• Laura N Reniker, MD

• Professional Counselor in Tarboro, NC
• Providers in Tarboro, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.