WILMINGTON HEALTH ACCESS FOR TEENS NPI 1063547990

NPI Information

NPI: 1063547990
Provider Name: WILMINGTON HEALTH ACCESS FOR TEENS
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1805 S 13TH ST
WILMINGTON, NC
ZIP 28401
Phone: (910) 772-5552
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WILMINGTON HEALTH ACCESS FOR TEENS is a mental health counselor in Wilmington, NC. WILMINGTON HEALTH ACCESS FOR TEENS NPI is 1063547990. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1805 S 13TH ST
WILMINGTON, NC
ZIP 28401-469
Phone: (910) 772-5552
Fax: (910) 772-5554

The provider's authorized official is Maria Van De Bovenkamp .
The authorized official title is Medical Office Administrator and has the following contact phone number (910) 790-9949.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6005591	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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