Tyson's Corner Health Services, Inc

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

TYSON'S CORNER HEALTH SERVICES, INC

Practice address

482 Williamston Dr
Winterville, NC 28590-9415

Phone

(252) 217-4681

Fax

(252) 364-2631

NPI assigned

Oct 24, 2012

Last updated

Oct 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Caspertine Anntionelle Hawkins, QP

Title

Ceo

Phone

(202) 531-6736

Specialties & licenses 7

Addresses

Tax ID family

Tyson's Corner Health Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Tyson's Corner Health Services, Inc.

  • Counselor
  • Rocky Mount, NC
  • NPI 1265713606
  NPD tax ID

Locations

Practitioners 1

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.

• Terry Lamont Speller Sr., LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Winterville, NC
  • NPI 1952679011
  NPD (past)

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1831442110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8317 SIX FORKS RD",
            "address_2": "STE. 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152104",
            "telephone_number": "252-217-4681",
            "fax_number": "252-364-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 WILLIAMSTON DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909415",
            "telephone_number": "252-217-4681",
            "fax_number": "252-364-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYSON'S CORNER HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "CASPERTINE",
        "authorized_official_middle_name": "ANNTIONELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-531-6736",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "QP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Winterville, NC
• Providers in Winterville, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.