THE VILLAGE BEHAVIORAL HEALTHCARE SERVICES, INC (NPI# 1164878880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164878880 |
| Entity Type | Organization |
| Organization Name | THE VILLAGE BEHAVIORAL HEALTHCARE SERVICES, INC |
| Practice Address |
3800 Shamrock Dr Charlotte NC 28215-3220 |
| Mailing Address |
9811 Parthenon Ct Apt B Charlotte NC 28262-0263 |
| Practice Telephone | 7046169524 |
| Practice Fax Number | 7044454582 |
| Mailing Telephone | 7048913481 |
| Mailing Fax Number | 7048659908 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2019-11-29 |
| Authorized Official Name | MALIK ASHHALI (OWNER, CLINICAL THERAPIST) |
| Authorized Official Telephone | 7048913481 |
| Authorized Official Credential | MSW, LCSW, LCAS, |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
3040 | NC | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C009966 | NC | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| One Village Behavioral Healthcare Services, Inc. | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6900 Farmingdale Dr, Charlotte, NC 282125551 | 7048913481 |
| Street Address |
3800 SHAMROCK DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28215-3220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275668857 | Shirena Andra James | Occupational Therapist | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2007-02-22 |
| 1194332064 | Karen Jean Bryant | Counselor | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2020-09-25 |
| 1992265151 | Aqueelah Iman Yasin | Physical Therapy Assistant | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2019-03-23 |
| 1730617622 | Brittany Lynnae Marshe | Physical Therapy Assistant | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2017-05-23 |
| 1699215046 | Kristen Nicole Thompson | Physical Therapy Assistant | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2017-03-05 |
| 1982142428 | Belinda M Spinner | Occupational Therapy Assistant | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2017-02-04 |
| 1689045817 | Kali R Nelson | Speech-Language Pathologist | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2015-10-14 |
| 1801279922 | Mindy Warfford | Occupational Therapy Assistant | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2015-07-07 |
| 1811376155 | Priyanka Hingne | Physical Therapist | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2015-05-19 |
| 1477941292 | Sandra Graunke | Physical Therapy Assistant | 3800 Shamrock Dr, Charlotte, NC 28215-3220 | 2014-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679111769 | Lawana Ussery Hill | Case Management | 1740 Misty Morn Drive, Charlotte, NC 28215 | 2019-12-19 |
| 1053961110 | Tonya Anita Brown | Behavior Technician | 10230 White Oak Rd, Charlotte, NC 28215 | 2019-09-19 |
| 1780242412 | Mikhail A Rybin | Registered Nurse | 7502 Malden Park Drive, Charlotte, NC 28215 | 2019-05-29 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1538646088 | Andrew Simpson | Pharmacist | 3805 Rocky River Rd, Charlotte, NC 28215 | 2018-07-26 |
| 1154818425 | Korinne A Umlauft | Specialist/Technologist | 8618 Terra Cotta Dr, Charlotte, NC 28215 | 2018-04-22 |
| 1477058196 | Harmony Health Pllc | Community/Behavioral Health | 8633 Pine Circle, Charlotte, NC 28215 | 2018-03-26 |
| 1639671357 | Total Renal Care of North Carolina LLC | Clinic/Center | 9562 Rocky River Rd, Charlotte, NC 28215 | 2018-03-08 |
| 1588166060 | Allcare Medical Center,pllc | Internal Medicine | 7401 The Plaza, Charlotte, NC 28215 | 2018-03-01 |
| 1851891774 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 3211 Bishops Way Lane, Charlotte, NC 28215 | 2018-02-16 |
| Find all providers in zip 28215 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184224727 | Kwanza Suzanne Winn | Social Worker | 2510 Hope Way Ln Apt 202, Charlotte, NC 28262-6955 | 2020-10-30 |
| 1164022570 | Directional Care Community Services LLC. | Social Worker | 6220 Sid Crane Dr, Charlotte, NC 28216-7684 | 2020-10-27 |
| 1710586698 | Queen City Psychotherapy Pllc | Social Worker | 100 Matador Ln Apt 403, Charlotte, NC 28209-3364 | 2020-10-21 |
| 1609474915 | Karen Doris Myers | Social Worker | 2503 Roswell Ave Unit 301, Charlotte, NC 28209-1683 | 2020-10-09 |
| 1750997540 | Patricia Mckinney | Social Worker | 4922 Albemarle Rd Ste 3a, Charlotte, NC 28205-6618 | 2020-09-17 |
| 1487260493 | Sarah Mcgeachy Greene | Social Worker | 1332 Morningside Dr., Charlotte, NC 28205 | 2020-09-16 |
| 1700499753 | Kelsey Dawn Miller | Social Worker | 3635 Manor House Dr, Charlotte, NC 28270-2291 | 2020-08-28 |
| 1104437847 | Delilah Mcdonald | Social Worker | 9812 Aviary Hill Way, Charlotte, NC 28214-7138 | 2020-08-15 |
| 1972114148 | Camari Claiborne-scott | Social Worker | 14026 Dingess Rd, Charlotte, NC 28273-3285 | 2020-08-12 |
| 1366050239 | Jacquelyne Aida Tingey | Social Worker | 5950 Fairview Rd Ste 660, Charlotte, NC 28210-3113 | 2020-07-16 |
| Find all providers in CHARLOTTE | ||||
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| 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.