STATEWIDE MENTAL HEALTH & DISABILITY SERVICES PLLC (NPI# 1588942239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588942239 |
| Entity Type | Organization |
| Organization Name | STATEWIDE MENTAL HEALTH & DISABILITY SERVICES PLLC |
| Practice Address |
622 Roanoke Ave Ste A Roanoke Rapids NC 27870-2740 |
| Mailing Address |
730 Roanoke Avenue Suite A-1 Roanoke Rapids NC 27870-2740 |
| Practice Telephone | 2523081247 |
| Mailing Telephone | 2523081247 |
| Mailing Fax Number | 2523081248 |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2017-07-17 |
| Authorized Official Name | KRISTIN CLAYTON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2523081247 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | COO3950 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6003794 | 05 |
| Street Address |
622 ROANOKE AVE STE A |
| City | ROANOKE RAPIDS |
| State | NC |
| Zip Code | 27870-2740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619359478 | Terresa Hall | Social Worker | 622 Roanoke Ave Ste A, Roanoke Rapids, NC 27870-2740 | 2015-06-29 |
| 1275926818 | Brittany Dunston | Social Worker | 622 Roanoke Ave Ste A, Roanoke Rapids, NC 27870-2740 | 2015-03-06 |
| 1568721082 | Larry Swinton | Counselor | 622 Roanoke Ave Ste A, Roanoke Rapids, NC 27870-2740 | 2012-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831721596 | Holt Assessment Services, LLC | Community/Behavioral Health | 622 Unit C Roanoke Avenue, Roanoke Rapids, NC 27870 | 2020-02-10 |
| 1053951244 | Wl Transportation LLC | Non-emergency Medical Transport (VAN) | 557 Litte Deep Creek Road, Roanoke Rapids, NC 27870 | 2020-01-15 |
| 1740748474 | Alexis S Gomez | Physician Assistant | 257 Nc-125, Roanoke Rapids, NC 27870 | 2019-03-12 |
| 1255874418 | Diane Shaw | Technician | 1015 Roanoke Avenue Suite A, Roanoke Rapids, NC 27870 | 2016-11-21 |
| 1568818912 | Adrianne Teague | Counselor | 60 N Highway 125, Roanoke Rapids, NC 27870 | 2016-05-04 |
| 1831552322 | Emergeortho, Pa | Durable Medical Equipment & Medical Supplies | 171 Nc Higway 125, Roanoke Rapids, NC 27870 | 2016-04-01 |
| 1710347885 | Golden Gate Human Services and Transportation | Counselor | 1028 Roanoke Avenue, Roanoke Rapids, NC 27870 | 2016-03-02 |
| 1811354905 | Michael D Turner | Physical Therapy Assistant | 171 Nc Highway 25, Roanoke Rapids, NC 27870 | 2016-01-21 |
| 1215323274 | D'vine Intervention Counseling Center | Community/Behavioral Health | 2424 Oak Street, Portsmouth, VA 27870 | 2015-04-07 |
| 1720408222 | Chastity Kinsler | Counselor | 60 North Highway 125, Roanoke Rapids, NC 27870 | 2014-04-23 |
| Find all providers in zip 27870 | ||||
| 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 |
|---|---|---|---|---|
| 1831721596 | Holt Assessment Services, LLC | Community/Behavioral Health | 622 Unit C Roanoke Avenue, Roanoke Rapids, NC 27870 | 2020-02-10 |
| 1841603461 | Universal Mental Health Services, Inc. | Community/Behavioral Health | 1405 Hinson St, Roanoke Rapids, NC 27870-3546 | 2014-06-11 |
| 1760895957 | Strategic Interventions, Inc | Community/Behavioral Health | 1441 Georgia Ave, Roanoke Rapids, NC 27870-4653 | 2014-06-05 |
| 1326463324 | C.a.r.e, Inc. (cognitive Achievement and Rehabilitative Enrichment | Community/Behavioral Health | 20 East 10th Street, Roanoke Rapids, NC 27870-9998 | 2014-02-27 |
| 1801222070 | C&m Behavioral Health, Pllc | Community/Behavioral Health | 1704 Highway 158, Roanoke Rapids, NC 27870 | 2013-09-19 |
| 1851726798 | Alpha Management Services, Inc. | Community/Behavioral Health | 140 Van Warren Rd, Roanoke Rapids, NC 27870-8743 | 2013-09-11 |
| 1750639563 | Family Preservation Services of North Carolina, Inc - Belmont | Community/Behavioral Health | 1517 Bolling Rd, Roanoke Rapids, NC 27840-1410 | 2012-08-28 |
| 1902154719 | Family Preservation Services of Nc, Inc - Manning | Community/Behavioral Health | 1102 Barrett St., Roanoke Rapids, NC 27870-3026 | 2012-08-28 |
| 1275881088 | Family Preservation Services of Nc, Inc - Chaloner | Community/Behavioral Health | 2100 Virginia Ave., Roanoke Rapids, NC 27870-4736 | 2012-08-28 |
| 1144559923 | Complete Therapy LLC | Community/Behavioral Health | 1043 Jackson St, Roanoke Rapids, NC 27870-3719 | 2009-12-08 |
| Find all providers in ROANOKE RAPIDS | ||||
| City | ROANOKE RAPIDS |
| Zip Code | 27870 |
Please comment or provide details below to improve the information on STATEWIDE MENTAL HEALTH & DISABILITY SERVICES PLLC.
| 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.