NPIMap

Organization Active NPI

St. Margaret Behavior Health Services LLC

  • Addiction (Substance Use Disorder) Counselor
  • Greenville, NC
National Provider Identifier
1790928752
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1065 Issued in NC
Legal business name
ST. MARGARET BEHAVIOR HEALTH SERVICES LLC
Practice address
3180 Ballards Crossroads Rd
Greenville, NC 27834-4707
Phone
(252) 227-4009
Fax
(252) 227-4009
NPI assigned
Apr 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Authorized official

Name
Mr. Collins Yeboa Siakwan, CLINICAL THERAPISTNPI 1538270913
Title
Chief Executive Officer
Phone
(252) 268-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X 1065 NC
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 1065 NC Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 1065 NC
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 1065 NC

Addresses

Primary practice location

3180 Ballards Crossroads Rd
Greenville, NC 27834-4707

Mailing address

3180 Ballards Crossroads Rd
Greenville, NC 27834-4707
Phone (252) 227-4009

Other identifiers 1

IdentifierTypeStateIssuer
6111899MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1790928752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 BALLARDS CROSSROADS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344707",
            "telephone_number": "252-227-4009",
            "fax_number": "252-227-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 BALLARDS CROSSROADS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344707",
            "telephone_number": "252-227-4009",
            "fax_number": "252-227-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARGARET BEHAVIOR HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "SIAKWAN",
        "authorized_official_first_name": "COLLINS",
        "authorized_official_middle_name": "YEBOA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "252-268-5433",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CLINICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NC",
            "license": "1065",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1065",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "1065",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "1065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111899",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; 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.