Pride in North Carolina, LLC
Organization Active NPI Community/Behavioral Health Agency · Greenville, NC
NPI 1760420186 · NPPES record last updated Aug 19, 2024
Key facts
- NPI
- 1760420186
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- PRIDE IN NORTH CAROLINA, LLC
- Practice address
- 231 Commerce St
Greenville, NC 27858-5029 - Phone
- (252) 321-8080
- NPI assigned
- Jun 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Jason Rutski
- Title
- Director of Business Operations
- Phone
- (910) 452-1460
Other NPIs on the same Medicare enrollment 3
Practitioners 117
-
Smeeta Prasai Bhatta, PMHNP
-
Allison Cooper, LCMHC, NCC
-
Alyson Anita Crush, MSW, LCSW
-
Bianca Nichole Haywood, MSW, LCSW
-
Stephanie Holderman, PMHNP-BC
-
Sherelle D Holley, PMHNP
-
Michael Chet Jernigan, PMHNP
-
Nicole Adams Maye, LCMHCA
-
Jennifer Mae Miller, PA-C
-
Janice Pepper O'Bryant, M.S,. LPA, LPC
-
Rebecca Lyn Patil, LMFT
-
Mytajha Charbarneau Rascoe, MSW, LCSW
-
Lina M Rios, LCMHC
-
Shuvechaya Siwakoti, PMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050711000558 | NC | Part B Supplier - Clinic/Group Practice | 9638105869 |
Receives reassigned benefits from 70 practitioners 3 other NPIs on this enrollment Practice locations: Raleigh, NC; Wilson, NC; Wilmington, NC; Smithfield, NC; Jacksonville, NC; Greenville, NC; Goldsboro, NC; Fayetteville, NC… |
National Provider Directory
Locations
407 S Griffin St
Ste J
Elizabeth City, NC 27909
Phone (252) 331-0322
208 Malloy St
Ste B
Goldsboro, NC 27534
Phone (984) 520-6080
2902 N Herritage St
#A
Kinston, NC 28501
Phone (252) 520-6740
5710 Oleander Dr
Ste 110
Wilmington, NC 28403
Phone (910) 769-1785
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | |||
| Psychologist |
103T00000X | |||
| Clinical Social Worker |
1041C0700X | |||
| Psychiatry Physician |
2084P0800X | |||
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Yes | ||
| Community/Behavioral Health Agency | 251S00000X | NC | ||
| Adult Mental Health Clinic/Center | 261QM0850X | MHL-067-186 | NC | |
| Adult Mental Health Clinic/Center | 261QM0850X | NC |
Addresses
Primary practice location
231 Commerce St
Greenville, NC 27858-5029
Mailing address
231 Commerce St
Greenville, NC 27858-5029
Phone (252) 321-8080
Other practice location 1
2416 Bedgood Dr SW
Wilson, NC 27893-8515
Phone (252) 265-9200
Other practice location 2
5710 Oleander Dr Ste 110
Wilmington, NC 28403-4722
Phone (910) 769-1785
Other practice location 3
5710 Oleander Dr Ste 208
Wilmington, NC 28403-4722
Phone (910) 769-1785
Other practice location 4
901 N Winstead Ave Ste 260
Rocky Mount, NC 27804-8757
Phone (252) 210-6530
Other practice location 5
7610 Falls Of Neuse Rd Ste 290
Raleigh, NC 27615-3307
Phone (919) 321-9702
Other practice location 6
2902 N Herritage St Ste A
Kinston, NC 28501-1580
Phone (252) 686-5020
Other practice location 7
3886 Henderson Dr
Jacksonville, NC 28546-5219
Phone (910) 938-9833
Other practice location 8
208 Malloy St Ste B
Goldsboro, NC 27534-4478
Phone (984) 520-6080
Other practice location 9
1540 Purdue Dr Ste 100
Fayetteville, NC 28303-5509
Phone (910) 900-4660
Other practice location 10
407 S Griffin St Ste J
Elizabeth City, NC 27909-4693
Phone (252) 331-0322
Other practice location 11
1400 West Church Street Ext.
Elizabeth City, NC 27909-4510
Phone (252) 331-0322
Other practice location 12
1319 N Brightleaf Blvd Ste F
Smithfield, NC 27577-4876
Phone (919) 934-1312
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6005302 | Medicaid | NC | |
| 6005356 | Medicaid | NC | |
| 6006660 | Medicaid | NC | |
| 8300245B | Medicaid | NC | |
| 8300245G | Medicaid | NC | |
| 8300247H | Medicaid | NC | |
| 8303103 | Medicaid | NC | |
| 017E1 | Other | NC | BCBSNC |
| 333347 | Other | NC | HEALTH CHOICE |
| 6006644 | Medicaid | NC | |
| 8300246G | Medicaid | NC | |
| 8300581G | Medicaid | NC | |
| 8300244H | Medicaid | NC | |
| 8300338B | Medicaid | NC | |
| 8300581B | Medicaid | NC | |
| 6005355 | Medicaid | NC | |
| 8300244 | Medicaid | NC | |
| 8300245H | Medicaid | NC | |
| 8300246B | Medicaid | NC | |
| 8300338 | Medicaid | NC | |
| 8703008 | Medicaid | NC | |
| 225175471 | Other | NC | HUMANA GOLD CHOICE |
| 341008 | Medicaid | NC | |
| 5900421 | Medicaid | NC | |
| 6005354 | Medicaid | NC | |
| 8300247G | Medicaid | NC | |
| 8300338H | Medicaid | NC | |
| 8300581H | Medicaid | NC | |
| 3410008 | Medicaid | NC | |
| 8300245 | Medicaid | NC | |
| 8300246H | Medicaid | NC | |
| 8300244B | Medicaid | NC | |
| 8300244G | Medicaid | NC | |
| 8300246 | Medicaid | NC | |
| 8300247 | Medicaid | NC | |
| 8300247B | Medicaid | NC | |
| 8300581 | Medicaid | NC |
Other providers in Greenville, NC
- Michael Joseph Price
- Patrice Nicole Price
- Veronica Dalton Price
- William L Price
- Richard Michael Priddy
- Pride in North Carolina, LLC
- Prime Agency LLC
- Mindy Prince
- Mary Kathleen Printz
- Priorities ABA, PLLC
All providers in Greenville, NC · Community/Behavioral Health Agency in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.