Nova Family Outreach LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

NOVA FAMILY OUTREACH LLC

Practice address

3008 White Meadow LN
Winston Salem, NC 27107-5541

Phone

(704) 968-2492

NPI assigned

Nov 30, 2024

Organization subpart

No

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

Authorized official

Name

Deanna Velazquez, LCMHC, LCAS-ANPI 1770007841

Title

Owner, Clinical Director

Phone

(704) 968-2492

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deanna Denise Velazquez, LCMHCA, LCASA

  • Mental Health Counselor
  • Dallas, NC
  • NPI 1770007841
  NPD Authorized official

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

{
    "created_epoch": "1732924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1962228486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668352",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282668352",
            "telephone_number": "704-968-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 WHITE MEADOW LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271075541",
            "telephone_number": "704-968-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA FAMILY OUTREACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-30",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "VELAZQUEZ",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "OWNER, CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "704-968-2492",
        "authorized_official_credential": "LCMHC, LCAS-A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Norwood
• Michael George Noujaim, M.D.
• Rawan Nour, MA, BCBA, LBA
• Nizar Darwish Noureddine, M.D.
• Nourished and Known, PLLC
• Novant Health
• Novant Health Employer Solutions, LLC
• Novant Health Employer Solutions, LLC
• Novant Health Employer Solutions, LLC
• Novant Health Employer Solutions, LLC

• All providers in Winston Salem, NC
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.