FORTITUDE PSYCHOLOGICAL SERVICES, INC. (NPI# 1780231878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780231878 |
| Entity Type | Organization |
| Organization Name | FORTITUDE PSYCHOLOGICAL SERVICES, INC. |
| Practice Address |
4900 Randall Pkwy Ste D Wilmington NC 28403-2831 |
| Practice Telephone | 9107997557 |
| Practice Fax Number | 9107997558 |
| Mailing Telephone | 9107997557 |
| Mailing Fax Number | 9107997558 |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |
| Authorized Official Name | ERIKA MCCULLOUGH-SIMPSON (CEO/OWNER) |
| Authorized Official Telephone | 9106208575 |
| Authorized Official Credential | MA, LPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
4900 RANDALL PKWY STE D |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-2831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780204297 | Healing Adults & Adolescents Residential Treatment Program LLC | Clinic/Center | 100 Stroud St, Wilmington, DE 19805-4842 | 2020-04-24 |
| 1750926465 | Gwen Borcyk, Msw, Lcsw, Pllc | Clinic/Center | 313 Walnut St Ste 106, Wilmington, NC 28401-4063 | 2019-11-18 |
| 1982117669 | Sound Psychologial Services, Pa | Clinic/Center | 3317 Masonboro Loop Rd Unit 160, Wilmington, NC 28409-2970 | 2017-11-16 |
| 1962859496 | Your Center, LLC | Clinic/Center | 222 Philadelphia Pike Ste 4, Wilmington, DE 19809-3166 | 2016-05-13 |
| 1720408586 | Merakey Allos | Clinic/Center | 101 Rogers Rd, Wilmington, DE 19801-5778 | 2014-04-21 |
| 1598185670 | Merakey Allos | Clinic/Center | 5574 Kirkwood Hwy, Wilmington, DE 19808-5002 | 2014-04-16 |
| 1275972333 | Merakey Allos | Clinic/Center | 5572 Kirkwood Hwy, Wilmington, DE 19808-5002 | 2013-06-21 |
| 1104173509 | Connections Community Support Programs, Inc. | Clinic/Center | 500 W. 10th Street, Wilmington, DE 19801 | 2012-08-06 |
| 1659676617 | Andrew W Donohue Do | Clinic/Center | 34 Harlech Dr, Wilmington, DE 19807-2508 | 2011-01-21 |
| 1558662346 | Focus Behavioral Health,llc | Clinic/Center | 410 Foulk Rd Ste 105, Wilmington, DE 19803-3835 | 2010-11-09 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
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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.