NPIMap

Organization Active NPI

North Carolina Children's Place, Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1932389475
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
NORTH CAROLINA CHILDREN'S PLACE, INC
Practice address
1001 S Marshall St Ste 256
Winston Salem, NC 27101-5852
Phone
(336) 505-0379
NPI assigned
Nov 13, 2007
Last updated
Nov 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Authorized official

Name
Alicia Y Clodfelter
Title
Vice President
Phone
(336) 449-9775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

1001 S Marshall St Ste 256
Winston Salem, NC 27101-5852

Mailing address

603 Greyrock Rd
Whitsett, NC 27377-9225
Phone (336) 449-9775

Other identifiers 1

IdentifierTypeStateIssuer
8301260MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
North Carolina Children's Place 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.

Locations

1001 S Marshall St
Ste 256
Winston Salem, NC 27101
Phone (336) 505-0379

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1932389475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 GREYROCK RD",
            "city": "WHITSETT",
            "state": "NC",
            "postal_code": "273779225",
            "telephone_number": "336-449-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S MARSHALL ST STE 256",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015852",
            "telephone_number": "336-505-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA CHILDREN'S PLACE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "CLODFELTER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-449-9775"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301260",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.