Edgecombe-Nash Mental Health Clinic Beacon Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EDGECOMBE-NASH MENTAL HEALTH CLINIC BEACON CENTER

Practice address

500 Nash Medical Arts Mall
Rocky Mount, NC 27804-1417

Phone

(252) 937-8141

Fax

(252) 443-9574

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Nancy Rackley

Title

Finance Officer

Phone

(252) 937-8141

Specialties & licenses 1

Addresses

Other identifiers 8

Tax ID family

Edgecombe Nash Mental Health2 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.

• Edgecombe Nash Mental Health

  • Mental Health Counselor
  • Tarboro, NC
  • NPI 1316045818
  NPD tax ID

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1740388347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NASH MEDICAL ARTS MALL",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041417",
            "telephone_number": "252-937-8141",
            "fax_number": "252-443-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NASH MEDICAL ARTS MALL",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041417",
            "telephone_number": "252-937-8141",
            "fax_number": "252-443-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGECOMBE-NASH MENTAL HEALTH CLINIC BEACON CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "RACKLEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "252-937-8141"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301065",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENDORSED PROVIDER NUMBER",
            "identifier": "3404937E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301065G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BASE PROVIDER NUMBER",
            "identifier": "3404937",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901411",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "0182",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408170",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005570",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.