INTEGRATED BEHAVIORAL HEALTH MANAGEMENT (NPI# 1780033233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780033233 |
| Entity Type | Organization |
| Organization Name | INTEGRATED BEHAVIORAL HEALTH MANAGEMENT |
| Practice Address |
10320 Mallard Creek Rd Suite 240 Charlotte NC 28262-5208 |
| Mailing Address |
10320 Mallard Creek Rd Ste 240 Charlotte NC 28262-5208 |
| Practice Telephone | 7049106142 |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-11-01 |
| Authorized Official Name | MS. MARYANN RICHARDSON (DIRECTOR) |
| Authorized Official Telephone | 7049106142 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
5004974 | NC | Ambulatory Health Care Facilities |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
5004974 | NC | Ambulatory Health Care Facilities |
| N | 251B00000X | Case Management | 5004974 | NC | Agencies |
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
5004974 | NC | Ambulatory Health Care Facilities |
| Y | 251S00000X | Community/Behavioral Health | 5006630 | NC | Agencies |
| Street Address |
10320 MALLARD CREEK RD SUITE 240 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912987975 | William G. Katibah IIi | Family Medicine | 10320 Mallard Creek Rd, Suite 100, Charlotte, NC 28262-9756 | 2006-01-18 |
| 1558775015 | Allison Petrilli Knox | Physician Assistant | 10320 Mallard Creek Rd, Suite 100, Charlotte, NC 28262-9756 | 2014-06-12 |
| 1881952117 | Carolinas Medical Center At Home, LLC | Durable Medical Equipment & Medical Supplies | 10320 Mallard Creek Rd, Suite 230, Charlotte, NC 28262-9756 | 2012-04-24 |
| 1982992376 | Rosemarie Gentle | Physical Therapist | 10320 Mallard Creek Rd, Suite 275, Charlotte, NC 28262-9756 | 2011-07-19 |
| 1578863007 | Stacy Marie Sannem | Physical Therapist | 10320 Mallard Creek Rd, Ste 275, Charlotte, NC 28262-9756 | 2010-11-01 |
| 1619208030 | S.j.burrow,iii.d.d.s.,m.s.,p.l.l.c. | Dentist | 10320 Mallard Creek Rd, Suite 150, Charlotte, NC 28262-9756 | 2010-01-25 |
| 1871735068 | Kimberly S Squires | Nurse Practitioner | 10320 Mallard Creek Rd, Ste 240, Charlotte, NC 28262-9756 | 2009-04-02 |
| 1801067327 | David H. Moore Dds, Ms, Pa | Dentist | 10320 Mallard Creek Rd, Suite 150, Charlotte, NC 28262-9756 | 2008-03-13 |
| 1518174820 | William George Katibah IIi | Family Medicine | 10320 Mallard Creek Rd, Suite 100, Charlotte, NC 28262-9756 | 2007-05-17 |
| 1639386162 | R. Holt Foushee, Dds, Ms | Clinic/Center | 10320 Mallard Creek Rd, Suite 140, Charlotte, NC 28262-9756 | 2007-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| 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 |
|---|---|---|---|---|
| 1053925099 | Essential Pathways Counseling and Consulting, Pllc | Community/Behavioral Health | 5009 Beatties Ford Rd Ste 107-274, Charlotte, NC 28216-2859 | 2020-09-08 |
| 1841809746 | Ryan's Place, LLC | Community/Behavioral Health | 6000 Fairview Rd Ste 1259, Charlotte, NC 28210-2224 | 2020-07-27 |
| 1760090641 | Compact Health Services LLC | Community/Behavioral Health | 7506 E Independence Blvd Ste 130-d, Charlotte, NC 28227-9471 | 2020-07-16 |
| 1366060170 | Stride | Community/Behavioral Health | 14054 Singleleaf Lane, Charlotte, NC 28278 | 2020-07-08 |
| 1114540093 | Curtis In Care LLC | Community/Behavioral Health | 10923 Chastain Parc Dr, Charlotte, NC 28216-7654 | 2020-05-26 |
| 1477174407 | Garden of Life, Inc | Community/Behavioral Health | 8339 Fox Swamp Rd, Charlotte, NC 28215-9011 | 2020-04-30 |
| 1134753601 | Luis Ariel Hernandez | Community/Behavioral Health | 6000 Fairview Rd # 1259, Charlotte, NC 28210-2224 | 2020-02-24 |
| 1205468774 | Windsong Family & Psychiatric Associates, Pllc | Community/Behavioral Health | 416 Mccullough Dr Ste 135, Charlotte, NC 28262-4389 | 2020-02-12 |
| 1265071542 | Counseling and Behavioral Therapy | Community/Behavioral Health | 16528 Silversword Dr, Charlotte, NC 28213-4876 | 2020-01-03 |
| 1578101283 | Davis Quality Care LLC | Community/Behavioral Health | 11623 Sweet Rose Ct, Charlotte, NC 28269-3407 | 2019-12-12 |
| 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.