Integrated Behavioral Health Management

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

INTEGRATED BEHAVIORAL HEALTH MANAGEMENT

Practice address

8430 Medical Plaza Dr Ste 300
Charlotte, NC 28262-9758

Phone

(704) 910-6142

Fax

(980) 422-0106

NPI assigned

Jun 6, 2016

Organization subpart

No

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

Authorized official

Name

Maryann Catherine RichardsonNPI 1235425323

Title

Director

Phone

(704) 910-6142

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Maryann Catherine Richardson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, NC
  • NPI 1235425323
  Medicare reassignment Authorized official
• Tanya Rachelle Dunlap

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1316447022

  Single Specialty

  NPD

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1780033233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 MEDICAL PLAZA DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629758",
            "telephone_number": "704-910-6142",
            "fax_number": "908-422-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 MEDICAL PLAZA DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629758",
            "telephone_number": "704-910-6142",
            "fax_number": "980-422-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED BEHAVIORAL HEALTH MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-910-6142"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "5004974",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "5004974",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NC",
            "license": "5004974",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "5004974",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.