Organization Active NPI

Behavioral Wellness Center of Shelby

  • Clinical Social Worker
  • Shelby, NC
National Provider Identifier
1770512907
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005250 Issued in NC
Legal business name
BEHAVIORAL WELLNESS CENTER OF SHELBY
Practice address
123 W Marion St
Shelby, NC 28150-5381
Phone
(704) 484-2100
Fax
(704) 484-0090
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gladys Turnes
Title
Administrator
Phone
(704) 484-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C005250 NC Primary

Addresses

Primary practice location

123 W Marion St
Shelby, NC 28150-5381

Mailing address

123 W Marion St
Shelby, NC 28150-5381
Phone (704) 484-2100

Other identifiers 2

IdentifierTypeStateIssuer
6005225MedicaidNC
89016GEMedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770512907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W MARION ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281505381",
            "telephone_number": "704-484-2100",
            "fax_number": "704-484-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W MARION ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281505381",
            "telephone_number": "704-484-2100",
            "fax_number": "704-484-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL WELLNESS CENTER OF SHELBY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TURNES",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-484-2100"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005225",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016GE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.