SOUTHLIGHT HEALTHCARE (NPI# 1255537114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255537114 |
| Entity Type | Organization |
| Organization Name | SOUTHLIGHT HEALTHCARE |
| Practice Address |
3125 Poplarwood Ct Suite 150 Raleigh NC 27604-1084 |
| Mailing Address |
3125 Poplarwood Ct. Suite 203 Raleigh NC 27604-6445 |
| Practice Telephone | 9197876131 |
| Practice Fax Number | 9195712932 |
| Mailing Telephone | 9197876131 |
| Mailing Fax Number | 9195712932 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2015-11-04 |
| Authorized Official Name | REYNOLDS CLODFELTER (CEO) |
| Authorized Official Telephone | 9198786131 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300533 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760811871 | Southlight Healthcare | Community/Behavioral Health | 1822 Gorman St, Apt. D, Raleigh, NC 27606-2984 | 2013-11-08 |
| 1962608919 | Southlight Healthcare | Community/Behavioral Health | 1952 Spring Dr, Garner, NC 27529-3486 | 2007-06-26 |
| 1164628020 | Southlight Healthcare | Counselor | 1012 Oberlin Rd, Suite 300, Raleigh, NC 27605-1135 | 2007-06-26 |
| 1932305885 | Southlight Healthcare | Counselor | 1012 Oberlin Rd., Suite 300, Raleigh, NC 27605-1396 | 2007-06-26 |
| 1447650478 | Southlight Healthcare | Community/Behavioral Health | 3125 Poplarwood Ct Ste 203, Raleigh, NC 27604-6445 | 2014-08-27 |
| 1255760278 | Southlight Healthcare | Community/Behavioral Health | 220 Swinburne Rd, Raleigh, NC 27610-1834 | 2013-11-12 |
| 1801132071 | Southlight Healthcare | Clinical Medical Laboratory | 2101 Garner Rd, Raleigh, NC 27610-4687 | 2012-12-17 |
| 1316268345 | Southlight Healthcare | Counselor | 2101 Garner Rd, Raleigh, NC 27610-4687 | 2010-06-14 |
| 1083933998 | Southlight Healthcare | Counselor | 2101 Garner Rd, Raleigh, NC 27610-4687 | 2010-05-18 |
| 1487821104 | Southlight Healthcare | Registered Nurse | 2101 Garner Rd, Raleigh, NC 27610-4687 | 2008-05-12 |
| Street Address |
3125 POPLARWOOD CT SUITE 150 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27604-1084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073557773 | Jewell S Mabery | Nurse Practitioner | 3125 Poplarwood Ct, Aspen Bldg, Suite 100, Raleigh, NC 27604-1084 | 2006-06-15 |
| 1700494572 | Vanessa Del Carmen | Counselor | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2020-07-17 |
| 1740809342 | Brittani Smith | Social Worker | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2020-04-13 |
| 1114586914 | Leah C Filomena | Social Worker | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2019-06-06 |
| 1437611902 | Jillian Elizabeth Lehmann | Social Worker | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2019-04-03 |
| 1124582929 | Anna Holloman | Social Worker | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2019-01-25 |
| 1417411422 | Hayley York Teague | Counselor | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2019-01-23 |
| 1568931855 | Doreen Lynn Miller | Counselor | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2018-11-16 |
| 1225517550 | Halee Spence Smith | Social Worker | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2018-08-08 |
| 1538695424 | Serena Wilson | Social Worker | 3125 Poplarwood Ct, Suite 103, Raleigh, NC 27604-1084 | 2017-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326669748 | Monet Josey | Counselor | 3020 Highwood Blvd, Raleigh, NC 27604 | 2020-04-27 |
| 1154979094 | Ride4health Transportation Inc | Non-emergency Medical Transport (VAN) | 3200 Capital Blvd, Raleigh, NC 27604 | 2019-09-03 |
| 1851890750 | Sasilana Letreva Burden | In Home Supportive Care | 4000 Northstone Drive Apt 307, Raleigh, NC 27604 | 2018-02-06 |
| 1093226383 | The Eye Institute Od, Pa | Optometrist | 111 Seaboard Ave Ste 110, Raleigh, NC 27604 | 2017-10-13 |
| 1902326044 | Ngozi Ifeoma Osiebo | Nurse Practitioner | 4608 Wedgewood Drive, Raleigh, NC 27604 | 2017-06-20 |
| 1144765520 | Rose Hill Family Care Home | Custodial Care Facility | 1705 Beacon Bluff Street, Raleigh, NC 27604 | 2016-12-21 |
| 1437609948 | Mercy Manor At Saybrooke, Inc | Custodial Care Facility | 6320 Saybrooke Drive, Raleigh, NC 27604 | 2016-10-07 |
| 1972969913 | Shivas Gilotra | Nurse Practitioner | 805 Oberlin Road, Ste 200, Raleigh, NC 27604 | 2016-01-06 |
| 1609247915 | Charisse Justine Young | Social Worker | 2609 Atlantic Avenue, Suite 111c, Raleigh, NC 27604 | 2015-10-13 |
| 1356748933 | John T Hart | Counselor | 1115-113 Cove Bridge Road, Raleigh, NC 27604 | 2014-11-26 |
| Find all providers in zip 27604 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688678 | Life Extensions LLC | Community/Behavioral Health | 4304 Coburn Pl Apt 106, Raleigh, NC 27616-7971 | 2020-04-19 |
| 1639716368 | Monarch | Community/Behavioral Health | 1705 Beacon Bluff St, Raleigh, NC 27604-5446 | 2019-12-02 |
| 1700429396 | Transcending Limits Counseling Services Pllc | Community/Behavioral Health | 3445 Teravista Way, Raleigh, NC 27616-9310 | 2019-10-25 |
| 1497397137 | Ever-lasting Counseling Service LLC | Community/Behavioral Health | 7730 Sunfield Cir Apt 303, Raleigh, NC 27617-6762 | 2019-10-15 |
| 1285108373 | Metro Treatment of North Carolina L P | Community/Behavioral Health | 3911 New Bern Ave, Raleigh, NC 27610-1332 | 2019-01-11 |
| 1932670999 | Elevation Community Services, LLC | Community/Behavioral Health | 3712 Benson Dr Ste 201-202, Raleigh, NC 27609-7328 | 2018-12-16 |
| 1891297222 | Saving Hope, LLC | Community/Behavioral Health | 2501 Lilymount Dr, Raleigh, NC 27610-3476 | 2018-03-01 |
| 1508370776 | Resiliency In Recovery | Community/Behavioral Health | 3986 Cane Garden Dr, Raleigh, NC 27610-5696 | 2017-11-27 |
| 1467975318 | Aci Support Specialists, LLC | Community/Behavioral Health | 6832 Planting Ct, Raleigh, NC 27610-8705 | 2017-07-24 |
| 1134649601 | Aci Support Specialists, LLC | Community/Behavioral Health | 12367 Honeychurch St, Raleigh, NC 27614-7879 | 2017-06-26 |
| Find all providers in RALEIGH | ||||
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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.