NPIMap

Organization Active NPI

Del Mar Support Services LLC

  • Behavior Analyst
  • Jacksonville, NC
National Provider Identifier
1770039323
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-11-6942 Issued in NC
Legal business name
DEL MAR SUPPORT SERVICES LLC
Practice address
1179 McCallister Rd
Jacksonville, NC 28540-8796
Phone
(910) 378-2501
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
Rebecca TaggNPI 1871872762
Title
Clinical Director
Phone
(910) 378-2501

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-11-6942 NC Primary

Addresses

Primary practice location

1179 McCallister Rd
Jacksonville, NC 28540-8796

Mailing address

1179 McCallister Rd
Jacksonville, NC 28540
Phone (910) 378-2501

Other names 1

  • Del Mar Center for Behavioral Health Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1770039323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 MCCALLISTER RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28540",
            "telephone_number": "910-378-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 MCCALLISTER RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285408796",
            "telephone_number": "910-378-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL MAR SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "TAGG",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "910-378-2501"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-11-6942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Del Mar Center for Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.