Physician Alliance for Mental Health LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHYSICIAN ALLIANCE FOR MENTAL HEALTH LLC

Practice address

3208 Oleander Dr
Wilmington, NC 28403-0800

Phone

(910) 794-3929

Fax

(910) 798-2303

NPI assigned

Jan 24, 2011

Last updated

Apr 10, 2014By 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

Wendy Rene' Kaczynski

Title

Provider Manager

Phone

(910) 262-7107

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Physician Alliance for Mental Health2 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.

• Physician Alliance for Mental Health

  • Case Management Agency
  • Wilmington, NC
  • NPI 1578868436
  NPD tax ID

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1942505987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15511",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085511",
            "telephone_number": "910-794-3929",
            "fax_number": "910-798-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284030800",
            "telephone_number": "910-794-3929",
            "fax_number": "910-798-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ALLIANCE FOR MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-24",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "KACZYNSKI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "RENE'",
        "authorized_official_title_or_position": "PROVIDER MANAGER",
        "authorized_official_telephone_number": "910-262-7107"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3410154",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy for Life
• Physical Therapy for Women, Inc
• Physical Therapy Services of Wilmington
• Physical Therapy Services of Wilmington at Porter's Neck, LLC
• Physician Alliance for Mental Health
• Physician Alliance for Mental Health, LLC
• Physician Alliance of Mental Health
• Physicians Choice Medical Equipment
• Panida Piboolnurak, MD
• Kelly Broadwater Pickell, MA, LPA, LPC, CEDS

• Community/Behavioral Health Agency in Wilmington, NC
• Providers in Wilmington, 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 Apr 10, 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.