NPIMap

Organization Active NPI

Stevens Healthcare Agency, Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, NC
National Provider Identifier
1902993348
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STEVENS HEALTHCARE AGENCY, INC.
Practice address
824 Gum Branch Rd Ste N
Jacksonville, NC 28540-6269
Phone
(910) 938-7200
Fax
(910) 938-7201
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Authorized official

Name
Dr. Linda Freeman Stevens
Title
President
Phone
(910) 938-7200

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 1206 NC
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 7145 NC
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C004946 NC
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Supports Brokerage Agency 251X00000X

Addresses

Primary practice location

824 Gum Branch Rd Ste N
Jacksonville, NC 28540-6269

Mailing address

824 Gum Branch Rd Ste N
Jacksonville, NC 28540-6269
Phone (910) 938-7200

Other identifiers 2

IdentifierTypeStateIssuer
8301546MedicaidNC
8301952MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sky Rizer'S Family Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

824 Gum Branch Rd
Ste N
Jacksonville, NC 28540
Phone (910) 938-7200

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1902993348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 GUM BRANCH RD STE N",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406269",
            "telephone_number": "910-938-7200",
            "fax_number": "910-938-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 GUM BRANCH RD STE N",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406269",
            "telephone_number": "910-938-7200",
            "fax_number": "910-938-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENS HEALTHCARE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "FREEMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-938-7200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1206",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7145",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004946",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301546",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301952",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.