Abc Play

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ABC PLAY

Practice address

1290 Halstead Blvd
Elizabeth City, NC 27909-5840

Phone

(252) 333-8445

Fax

(252) 404-9136

NPI assigned

Feb 10, 2015

Organization subpart

No

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

Authorized official

Name

Wilkiam Wilson, BS, MS, ITFS, LCAS-ANPI 1558779298

Title

Ifts, Lcas-a

Phone

(252) 312-0516

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Wilkiam Wilson

  • Addiction (Substance Use Disorder) Counselor
  • Elizabeth City, NC
  • NPI 1558779298

  Early Intervention Provider Agency

  NPD Authorized official

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1780075952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1614",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279061614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 HALSTEAD BLVD",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279095840",
            "telephone_number": "252-333-8445",
            "fax_number": "252-404-9136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 Ray St",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279095156",
            "country_code": "US",
            "telephone_number": "252-312-0516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ABC PLAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILKIAM",
        "authorized_official_title_or_position": "IFTS, LCAS-A",
        "authorized_official_telephone_number": "252-312-0516",
        "authorized_official_credential": "BS, MS, ITFS, LCAS-A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.