ALPHA NEUROBEHAVIORAL CLINIC (NPI# 1154797033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154797033 |
| Entity Type | Organization |
| Organization Name | ALPHA NEUROBEHAVIORAL CLINIC |
| Practice Address |
200 Valencia Dr Suite 194 Jacksonville NC 28546-6311 |
| Mailing Address |
150 Old Beechtree Ln Jacksonville NC 28540-8808 |
| Practice Telephone | 9109390622 |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-11-04 |
| Authorized Official Name | MR. GREGORY THOMAS PEARCE (PARTNER / CO-OWNER) |
| Authorized Official Telephone | 9107502879 |
| Authorized Official Credential | MA, LPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
200 VALENCIA DR SUITE 194 |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982688180 | Judith Tart Kettner | Counselor | 200 Valencia Dr, Suite 109, Jacksonville, NC 28546-7356 | 2005-12-01 |
| 1730584244 | Refuge Counseling & Consulting Services | Community/Behavioral Health | 200 Valencia Dr, Jacksonville, NC 28546-6311 | 2014-10-27 |
| 1649514605 | Brigita Sunshyne Baumgardner Lcsw Pa | Social Worker | 200 Valencia Dr, Suite 101, Jacksonville, NC 28546-6311 | 2012-11-15 |
| 1184900805 | Wilmina Beaumont Rosario | Counselor | 200 Valencia Dr, Jacksonville, NC 28546-6311 | 2011-10-26 |
| 1699050971 | Golden Gates Homecare Agency, LLC | In Home Supportive Care | 200 Valencia Dr, Suite 165, Jacksonville, NC 28546-6311 | 2011-10-18 |
| 1235417213 | Veronica Weaver | Counselor | 200 Valencia Dr, Suite 161, Jacksonville, NC 28546-6311 | 2011-07-25 |
| 1528353729 | Coastal Neurotherapy, P.a. | Clinical Neuropsychologist | 200 Valencia Dr, Suite 109, Jacksonville, NC 28546-6311 | 2011-06-15 |
| 1437451747 | Michelina H Therrien Lcsw Pa | Social Worker | 200 Valencia Dr, Suite 101, Jacksonville, NC 28546-6311 | 2010-11-19 |
| 1477863355 | Malachi Home Care,inc | Nursing Facility/Intermediate Care Facility | 200 Valencia Dr, Suite 103, Jacksonville, NC 28546-6311 | 2010-10-13 |
| 1518190511 | Suzan Douville | Counselor | 200 Valencia Dr, Suite 135, Jacksonville, NC 28546-6311 | 2009-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740224 | North Florida Collaborative Therapy | Psychologist | 9652 Morgan Creek Ct, Jacksonville, FL 32222-5808 | 2020-11-05 |
| 1306456058 | Southern Oregon Cbt LLC | Psychologist | 690 G St Ste C, Jacksonville, OR 97530-3208 | 2020-08-07 |
| 1013408004 | Marisa Victoria Byles | Psychologist | 12443 San Jose Blvd Ste 202, Jacksonville, FL 32223-8648 | 2018-05-24 |
| 1306203245 | Robin Jones | Psychologist | 200 Valencia Dr Ste 194, Jacksonville, NC 28546-6311 | 2016-01-22 |
| 1336510452 | Nour Mahmoud Abdelghani | Psychologist | 524 Skymarks Dr Unit 5, Jacksonville, FL 32218-7254 | 2015-10-15 |
| 1295105823 | Mhealthcare Co. | Psychologist | 3805 Valencia Rd, Jacksonville, FL 32205-9271 | 2015-09-24 |
| 1629406400 | Max Aaron Horovitz | Psychologist | 10475 Centurion Pkwy N Ste 301, Jacksonville, FL 32256-5004 | 2013-10-14 |
| 1457786915 | Coral Gaffney | Psychologist | 6488 103rd St., Ste B, Jacksonville, FL 32210 | 2013-09-03 |
| 1801236542 | Jeffrey Allan Rommel | Psychologist | 11150 Castlemain Cir S, Jacksonville, FL 32256-4825 | 2013-06-26 |
| 1326483017 | Amy Melinda Hartley | Psychologist | 8355 Merchants Gate Dr, Jacksonville, FL 32222-5848 | 2013-05-08 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on ALPHA NEUROBEHAVIORAL CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.