NPIMap

Organization Active NPI

Family Service of the Piedmont, Inc

  • Mental Health Counselor
  • Jamestown, NC
National Provider Identifier
1871672550
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAMILY SERVICE OF THE PIEDMONT, INC
Practice address
902 Bonner Dr
Jamestown, NC 27282-8948
Phone
(336) 387-6161
Fax
(336) 387-9167
NPI assigned
Nov 3, 2006
Last updated
Apr 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Authorized official

Name
Thomas F. Campbell, LPCNPI 1871790378
Title
President.Ceo
Phone
(336) 889-6105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 1874 NC
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

902 Bonner Dr
Jamestown, NC 27282-8948

Mailing address

902 Bonner Dr
Jamestown, NC 27282-8948
Phone (336) 387-6161

Other identifiers 1

IdentifierTypeStateIssuer
6005826MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Family Service of the Piedmont18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1871672550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BONNER DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828948",
            "telephone_number": "336-387-6161",
            "fax_number": "336-387-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 BONNER DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828948",
            "telephone_number": "336-387-6161",
            "fax_number": "336-387-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE OF THE PIEDMONT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT.CEO",
        "authorized_official_telephone_number": "336-889-6105",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1874",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005826",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.