Suws of the Carolinas

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-059-032 Issued in NC

Legal business name

SUWS OF THE CAROLINAS

Practice address

363 Graphite Rd
Old Fort, NC 28762-9455

Phone

(828) 668-7590

Fax

(828) 668-3162

NPI assigned

Jun 2, 2010

Last updated

Jun 2, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

CRC HEALTHAs reported in NPPES

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

Authorized official

Name

Mrs. Leah Madamba, LPC, NCC

Title

Program Director

Phone

(828) 668-7590

Specialties & licenses 1

Addresses

Tax ID family

Suws of the Carolinas2 organizations share this tax ID, including this one

Part of

Suws of the Carolinas

Other organizations with this tax ID 1

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

• Suws of the Carolinas

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Old Fort, NC
  • NPI 1740470798
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine Alice Cennamo, LCSW

  • Clinical Social Worker
  • Old Fort, NC
  • NPI 1588142707
  NPD (past)
• Kevin Waller, LPCS, LCAS, CCS

  • Addiction (Substance Use Disorder) Counselor
  • Old Fort, NC
  • NPI 1023596244
  NPD (past)
• James B Skelton, LCSW, LCAS,LADC, CSI

  • Clinical Social Worker
  • Portland, ME
  • NPI 1184263659
  NPD (past)

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1992025860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 GRAPHITE RD",
            "city": "OLD FORT",
            "state": "NC",
            "postal_code": "287629455",
            "telephone_number": "828-668-7590",
            "fax_number": "828-668-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 GRAPHITE RD",
            "city": "OLD FORT",
            "state": "NC",
            "postal_code": "287629455",
            "telephone_number": "828-668-7590",
            "fax_number": "828-668-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUWS OF THE CAROLINAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRC HEALTH",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "MADAMBA",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "828-668-7590",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-059-032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Shtymak, PA
• Katelind Smith, MSW
• Jennifer Ann Stulck, LCMHC
• John Robert Summerour, RPH
• Suws of the Carolinas
• The McDowell Hospital Inc (Mission Community Medicine Old Fort)
• Jon Charles Tripp, L.P.C.
• Kevin Waller, LPCS, LCAS, CCS
• Ware Family Medicine PLLC
• Brian Michael Ware, D.O.

• Emotionally Disturbed Childrens' Residential Treatment Facility in Old Fort, NC
• Providers in Old Fort, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.