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CARDINAL CLINIC LLC NPI 1982761250


NPI Information

NPI: 1982761250
Provider Name: CARDINAL CLINIC LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
1540 PURDUE DR STE 200
FAYETTEVILLE, NC
ZIP 28303
Phone: (910) 867-8889
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CARDINAL CLINIC LLC is a community behavioral health in Fayetteville, NC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. CARDINAL CLINIC LLC NPI is 1982761250. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1540 PURDUE DR STE 200
FAYETTEVILLE, NC
ZIP 28303-510
Phone: (910) 867-8889

The provider's authorized official is Tony Garcia .
The authorized official title is Qm Coordinator and has the following contact phone number (910) 864-0187.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 5/20/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2101YM0800XCounselorMental HealthNo
3101YP2500XCounselorProfessionalNo
4103T00000XPsychologistNo
5103TC2200XPsychologistClinical Child & AdolescentNo
6251S00000XCommunity/Behavioral HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18300391MEDICAIDNORTH 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

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