NPIMap

Organization Active NPI

Deep River Behavioral Health PLLC

  • Clinical Social Worker
  • High Point, NC
National Provider Identifier
1770367765
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DEEP RIVER BEHAVIORAL HEALTH PLLC
Practice address
3980 Premier Drive
Suite 110, PMB 1038
High Point, NC 27265-8409
Phone
(336) 298-8080
NPI assigned
Aug 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Robert JordanNPI 1316966419
Title
Owner
Phone
(336) 298-8080

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3980 Premier Drive
Suite 110, PMB 1038
High Point, NC 27265-8409

Mailing address

3980 Premier Drive
Suite 110, PMB 1038
High Point, NC 27265-8409
Phone (336) 298-8080

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": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1770367765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 PREMIER DRIVE",
            "address_2": "SUITE 110, PMB 1038",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658409",
            "telephone_number": "336-298-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 PREMIER DRIVE",
            "address_2": "SUITE 110, PMB 1038",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658409",
            "telephone_number": "336-298-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP RIVER BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-298-8080"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2023; 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.