NPIMap

Organization Active NPI

Roanoke Valley Special Services LLC

  • Professional Counselor
  • Garysburg, NC
National Provider Identifier
1790017812
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6604 Issued in NC
Legal business name
ROANOKE VALLEY SPECIAL SERVICES LLC
Practice address
505 Old Hwy
Garysburg, NC 27831-0443
Phone
(252) 536-0700
Fax
(252) 536-0702
NPI assigned
Feb 1, 2010
Last updated
Feb 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Bernice L Lee, M.ED, BA
Title
Ceo/Director
Phone
(252) 536-0700

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X NU
Professional Counselor 101YP2500X 6604 NC Primary
Social Worker 104100000X NU
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

505 Old Hwy
Garysburg, NC 27831-0443

Mailing address

505 Old Hwy
Garysburg, NC 27831-0443
Phone (252) 536-0700

Other identifiers 1

IdentifierTypeStateIssuer
8301881MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Roanoke Valley Special Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1790017812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 OLD HWY",
            "city": "GARYSBURG",
            "state": "NC",
            "postal_code": "278310443",
            "telephone_number": "252-536-0700",
            "fax_number": "252-536-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 OLD HWY",
            "city": "GARYSBURG",
            "state": "NC",
            "postal_code": "278310443",
            "telephone_number": "252-536-0700",
            "fax_number": "252-536-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE VALLEY SPECIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "252-536-0700",
        "authorized_official_credential": "M.ED, BA"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "6604",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301881",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garysburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.