NPIMap

Organization Active NPI

Family Preservation Services of NC, Inc.

  • Community/Behavioral Health Agency
  • Durham, NC
National Provider Identifier
1972641983
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY PRESERVATION SERVICES OF NC, INC.
Practice address
2609 N Duke St
Suite 504
Durham, NC 27704-3048
Phone
(919) 401-1151
NPI assigned
Feb 2, 2007
Last updated
Jan 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Authorized official

Name
Miranda Kaye Little
Title
NC Qi & Training Dir
Phone
(704) 344-0491

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Psychologist 103T00000X
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Psychologist 103TC0700X
Counseling Psychologist 103TC1900X
Clinical Child & Adolescent Psychologist 103TC2200X
School Psychologist 103TS0200X
Social Worker 104100000X
Marriage & Family Therapist 106H00000X
Community/Behavioral Health Agency 251S00000X Primary
Health Psychologist 103TH0004X

Addresses

Primary practice location

2609 N Duke St
Suite 504
Durham, NC 27704-3048

Mailing address

10304 Spotsylvania Ave
Suite 300
Fredericksburg, VA 22408-8602
Phone (540) 710-6085

Other identifiers 1

IdentifierTypeStateIssuer
6005324MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000148 NC Part B Supplier - Clinic/Group Practice 7214028539 Receives reassigned benefits from 15 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hendersonville, NC; Forest City, NC; Columbus, NC; Charlotte, NC; Asheville, NC

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1972641983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 SPOTSYLVANIA AVE",
            "address_2": "SUITE 300",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088602",
            "telephone_number": "540-710-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 N DUKE ST",
            "address_2": "SUITE 504",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277043048",
            "telephone_number": "919-401-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRESERVATION SERVICES OF NC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "NC QI & TRAINING DIR",
        "authorized_official_telephone_number": "704-344-0491"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005324",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.