Carolina Community Intervention Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CAROLINA COMMUNITY INTERVENTION SERVICES, LLC

Practice address

2028 Renner St
Charlotte, NC 28216-5168

Phone

(847) 887-9051

NPI assigned

Jul 7, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Jerard J Collins

Title

Chief Executive Officer

Phone

(847) 887-9051

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1992092159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 RENNER ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282165168",
            "telephone_number": "847-887-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 RENNER ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282165168",
            "telephone_number": "847-887-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA COMMUNITY INTERVENTION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "JERARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "847-887-9051",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Clinical Research, LLC
• Carolina Communication Consultants, LLC
• Carolina Community Group
• Carolina Community Group
• Carolina Community Group Triad
• Carolina Complete Psychiatry, PLLC
• Carolina Compound, LLC
• Carolina Concierge Therapeutics, PLLC
• Carolina Counseling Co PLLC
• Carolina Counseling Group, LLC

• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, 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 Jun 15, 2015; 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.