Ceiba Counseling Center, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CEIBA COUNSELING CENTER, INC.

Practice address

3509 Haworth Dr
Suite 304
Raleigh, NC 27609-7238

Phone

(919) 844-6348

Fax

(919) 844-6349

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Alfred Gonzalez, CCS, LCAS

Title

Executive Director

Phone

(919) 844-6348

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1881735256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 HAWORTH DR",
            "address_2": "SUITE 304",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097238",
            "telephone_number": "919-873-1551",
            "fax_number": "919-873-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 HAWORTH DR",
            "address_2": "SUITE 304",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097238",
            "telephone_number": "919-844-6348",
            "fax_number": "919-844-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEIBA COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-844-6348",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CCS, LCAS"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005447",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

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