CHILDREN'S HEALTH OF CAROLINA DBA PEMBROKE PEDIATRICS MENTAL HEALTH (NPI# 1679768303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679768303 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S HEALTH OF CAROLINA DBA PEMBROKE PEDIATRICS MENTAL HEALTH |
| Practice Address |
400 Liberty Hill Rd Lumberton NC 28358-2446 |
| Mailing Address |
812 Candy Park Rd Pembroke NC 28372-9129 |
| Practice Telephone | 9107388060 |
| Practice Fax Number | 9106713600 |
| Mailing Telephone | 9105210201 |
| Mailing Fax Number | 9105210773 |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2007-09-06 |
| Authorized Official Name | ROSE DUCKWORTH (COMPLIANCE OFFICER) |
| Authorized Official Telephone | 9107388060 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDREN'S HEALTH OF CAROLINA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 890253U | 05 |
| Street Address |
400 LIBERTY HILL RD |
| City | LUMBERTON |
| State | NC |
| Zip Code | 28358-2446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528064599 | William Scott Ryan | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2005-06-24 |
| 1699305060 | Jacklynn Lindsey Hunt | Physician Assistant | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2020-01-24 |
| 1376181487 | Jessica Nicole Fairfax | Nurse Practitioner | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2019-12-19 |
| 1174031173 | Danielle Nicole Chavis | Physician Assistant | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2018-01-12 |
| 1417467408 | Kandis Danielle Atkins | Family Medicine | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2017-10-04 |
| 1881126738 | Michelle Lin | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2017-03-30 |
| 1255764536 | Candace Michelle Lowry | Nurse Practitioner | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2013-08-09 |
| 1124371646 | Coastal Childrens Services Pllc | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2012-10-22 |
| 1689924268 | Christie Lynne Hagan | Physician Assistant | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2012-09-11 |
| 1063760031 | Children's Health of Carolina, Pa | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2012-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649812397 | Monarch | Community/Behavioral Health | 13128 Serenity Street, Huntersville, NC 28358 | 2019-10-15 |
| 1114577194 | Lashonda Patrice Bostic | Social Worker | 4719 Fayetteville Road, Lumberton, NC 28358 | 2019-09-12 |
| 1780232389 | Rosaline Whittington | Technician | 39 Sibley Road, Lumberton, NC 28358 | 2019-08-28 |
| 1790343168 | Emily Graham | Social Worker | 401 S. 27th Street, Lumberton, NC 28358 | 2019-05-31 |
| 1316420722 | Karen Lynn Warwick | Nurse Practitioner | 600 Farringdom St # Ab, Lumberton, NC 28358 | 2018-09-11 |
| 1982184149 | Virginia Feldick Hampton | Speech-Language Pathologist | Coastal Therapy Partners, 210 Liberty Hill Road, Lumberton, NC 28358 | 2018-08-17 |
| 1366941882 | Ashlynn Faircloth Mckeithan | Occupational Therapist | 210 Liberty Hill Road, Lumberton, NC 28358 | 2018-02-10 |
| 1992153506 | Matthew Mercer | Nurse Anesthetist, Certified Registered | 2703 Riverwood Ave, Lumberton, NC 28358 | 2016-05-25 |
| 1295100964 | Chosen Health Care Services Inc | In Home Supportive Care | 705b Wesley Pines Road, Lumberton, NC 28358 | 2015-12-07 |
| 1346626173 | Brittany Renea Chavis | Social Worker | 888 Wire Grass Road, Lumberton, NC 28358 | 2015-08-04 |
| Find all providers in zip 28358 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659846541 | Cassaundra Paige Locklear | Counselor | 1560 Oak Grove Church Road, Lumberton, NC 28360 | 2018-10-08 |
| 1902322795 | Evelyn Jemison-coleman | Counselor | 2105 E Elizabethtown Rd, Lumberton, NC 28358-3107 | 2017-08-14 |
| 1588103634 | Natasha Tamika Mcdaniels | Counselor | 602 Holland Pl, Lumberton, NJ 08048-3112 | 2017-02-21 |
| 1104293257 | Larina Mcdonald | Counselor | 2 Clove Ct, Lumberton, NJ 08048-4212 | 2015-08-25 |
| 1891197158 | Anthony Eldridge | Counselor | 662 Main St Ste B, Lumberton, NJ 08048-5014 | 2014-09-18 |
| 1538560826 | Jennifer Martin | Counselor | 56 Ginger Dr, Lumberton, NJ 08048-4204 | 2014-09-05 |
| 1790184695 | Kimberly Stoneking | Counselor | 79a Chestnut St, Lumberton, NJ 08048-1134 | 2014-08-15 |
| 1578962486 | Anne Greenwood | Counselor | 79 Chestnut Street, Lumberton, NJ 08048 | 2014-08-15 |
| 1568861631 | Naamah Curry I | Counselor | 3 Clove Ct, Lumberton, NJ 08048-4212 | 2014-08-14 |
| 1225446917 | Kendall Dempsey | Counselor | 1 Marriott Dr, Lumberton, NJ 08048-5235 | 2014-07-26 |
| Find all providers in LUMBERTON | ||||
Please comment or provide details below to improve the information on CHILDREN'S HEALTH OF CAROLINA DBA PEMBROKE PEDIATRICS MENTAL HEALTH.
| 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.