Living Well Behavioral Health, Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LIVING WELL BEHAVIORAL HEALTH, INC.

Practice address

2350 Bentridge LN
Suite 300
Fayetteville, NC 28304-0590

Phone

(910) 565-2322

Fax

(910) 479-1401

NPI assigned

Aug 1, 2016

Organization subpart

Yes

Parent organization

LIVING WELL BEHAVIORAL HEALTH, INC.As reported in NPPES

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

Authorized official

Name

Patricia Deleuran

Title

President

Phone

(910) 565-2322

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Living Well Behavioral Health Inc

  • Psychiatry Physician
  • Garner, NC
  • NPI 1649430489

  O20081006000131

  Same enrollment

Tax ID family

Living Well Behavioral Health Lab5 organizations share this tax ID, including this one

Part of

Living Well Behavioral Health Lab

Other organizations with this tax ID 4

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

• Living Well Behavioral Health Inc

  • Psychiatry Physician
  • Garner, NC
  • NPI 1649430489
  NPD tax ID
• Living Well Behavioral Health Lab

  • Clinical Medical Laboratory
  • Fayetteville, NC
  • NPI 1619349107
  NPD tax ID
• Living Well Behavioral Health, Inc.

  • Psychiatry Physician
  • Knightdale, NC
  • NPI 1356236772
  NPD tax ID
• Living Well Behavioral Health, Inc.

  • Psychiatry Physician
  • Fayetteville, NC
  • NPI 1487549804
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen David Jones, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, NC
  • NPI 1720322688
  NPD
• William Oliver Mann, D.O.

  • Psychiatry Physician
  • Wilson, NC
  • NPI 1649211715
  NPD

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470009600000",
    "number": "1790238335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 BENTRIDGE LN",
            "address_2": "SUITE 300",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040590",
            "telephone_number": "910-565-2322",
            "fax_number": "910-479-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 BENTRIDGE LN",
            "address_2": "SUITE 300",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040590",
            "telephone_number": "910-565-2322",
            "fax_number": "910-479-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVING WELL BEHAVIORAL HEALTH, INC.",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A",
        "authorized_official_last_name": "DELEURAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-565-2322"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950272",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Living in Full Excellence
• Living Waters Group Home
• Living Waters Group Home
• Living Well Behavioral Health Lab
• Living Well Behavioral Health, Inc.
• Living Well Counseling and Consulting Services PLLC
• Mary H. Livingston, M.ED., LPC, NCC
• Livingwaters
• Kaylie Lizotte
• Krizzlie Anne Dawang Lleva

• Psychiatry Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.