SOUTHLIGHT HEALTHCARE (NPI# 1508062548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508062548 |
| Entity Type | Organization |
| Organization Name | SOUTHLIGHT HEALTHCARE |
| Practice Address |
2101 Garner Rd Raleigh NC 27610-4687 |
| Mailing Address |
3125 Poplarwood Court Suite 203 Raleigh NC 27604-6445 |
| Practice Telephone | 9198324453 |
| Practice Fax Number | 9198291357 |
| Mailing Telephone | 9197876131 |
| Mailing Fax Number | 9195712932 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2014-04-30 |
| Authorized Official Name | DR. REYNOLDS C CLODFELTER (CEO) |
| Authorized Official Telephone | 9197876131 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MHL092169 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300525Q | 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 |
2101 GARNER RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-4687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356491914 | James Cuomo | Counselor | 2101 Garner Rd, Suite 107, Raleigh, NC 27610-4687 | 2007-01-12 |
| 1023646262 | Chandni Bhalodia | Physician Assistant | 2101 Garner Rd, Raleigh, NC 27610-0114 | 2020-04-01 |
| 1114553310 | Dawn Daniels | Counselor | 2101 Garner Rd, Raleigh, NC 27610-0114 | 2020-03-19 |
| 1689220303 | Leslianne Patricia Davis | Social Worker | 2101 Garner Rd, Raleigh, NC 27610-0114 | 2019-08-19 |
| 1871151878 | Marian Lansdell Edwards | Counselor | 2101 Garner Rd, Raleigh, NC 27610-0114 | 2019-06-04 |
| 1376008839 | Christopher John Mullen | Social Worker | 2101 Garner Rd, Raleigh, NC 27610-0114 | 2019-02-08 |
| 1558844795 | Ashley Ingram | Social Worker | 2101 Garner Rd, Raleigh, NC 27610-0114 | 2018-09-13 |
| 1578056834 | Megan Fries | Social Worker | 2101 Garner Rd, Raleigh, NC 27610 | 2018-06-12 |
| 1689165193 | Jazmin Stephanie Gonzalez | Counselor | 2101 Garner Rd, Raleigh, NC 27610 | 2018-05-21 |
| 1821505678 | Oviston Welch | Counselor | 2101 Garner Rd, Raleigh, NC 27610-0114 | 2018-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| 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.