Cornucopia Wellness Group, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CORNUCOPIA WELLNESS GROUP, LLC

Practice address

115 E Harden St
Suite 105
Graham, NC 27253-3001

Phone

(919) 808-5540

NPI assigned

May 2, 2017

Last updated

May 2, 2017By 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. Tiffany Garris, LCASNPI 1962755025

Title

Director

Phone

(919) 808-5540

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, and the practitioner matching its NPPES authorized official.

• Tiffany Christchaun Garris, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Durham, NC
  • NPI 1962755025
  NPD (past) Authorized official

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1871029595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E HARDEN ST",
            "address_2": "SUITE 105",
            "city": "GRAHAM",
            "state": "NC",
            "postal_code": "272533001",
            "telephone_number": "919-808-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E HARDEN ST",
            "address_2": "SUITE 105",
            "city": "GRAHAM",
            "state": "NC",
            "postal_code": "272533001",
            "telephone_number": "919-808-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNUCOPIA WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "GARRIS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-808-5540",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCAS"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Christopher Caudle
• Larry Grady Causey, D.D.S.
• Phillip T Chapman
• Abby Nicole Clayton, MS,OTR/L
• Cornerstone of Hope & Healing Counseling PLLC
• Dayna Cotugno, PA-C
• CPW Transportation, LLC
• Jerome M Crayle, DDS
• Crissman Family Practice
• Mark Anders Crissman, M.D.

• Community/Behavioral Health Agency in Graham, NC
• Providers in Graham, 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 May 2, 2017; 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.