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CMC-NORTHEAST INC. NPI 1184777617


NPI Information

NPI: 1184777617
Provider Name: CMC-NORTHEAST, INC.

Doing Business As: NORTHEAST PSYCHIATRIC SERVICES - ALBEMARLE

Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
105 YADKIN STREET
SUITE 302
ALBEMARLE, NC
ZIP 28001
Phone: (704) 403-1877
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CMC-NORTHEAST, INC. is a psychiatry psychiatry neurology in Albemarle, NC. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. CMC-NORTHEAST, INC. NPI is 1184777617. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Northeast Psychiatric Services - Albemarle.

The provider's business location address is:

105 YADKIN STREET
SUITE 302
ALBEMARLE, NC
ZIP 28001-454
Phone: (704) 403-1877
Fax: (704) 986-2150

The provider's authorized official is Frieda M Lowder .
The authorized official title is Vp Physician Services and has the following contact phone number (704) 403-4146.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 6/1/2012.


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
1101Y00000XCounselorNo
2103T00000XPsychologistNo
3103TC2200XPsychologistClinical Child & AdolescentNo
41041C0700XSocial WorkerClinicalNo
5106H00000XMarriage & Family TherapistNo
6363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
7101YP2500XCounselorProfessionalNo
8103TC0700XPsychologistClinicalNo
9103TA0400XPsychologistAddiction (Substance Use Disorder)No
10103TF0000XPsychologistFamilyNo
112084P0800XPsychiatry & NeurologyPsychiatryYes

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
189015E5MEDICAIDNORTH CAROLINA
25906956MEDICAIDNORTH CAROLINA
32325363MEDICARE PINNORTH CAROLINA
4019G5OTHERNORTH CAROLINABCBS EFF 7-1-07
5232009MEDICARE PINNORTH CAROLINA
6=========020OTHERNORTH CAROLINATRICARE EFFECTIVE 7/1/07
7B948OTHERNORTH CAROLINAPARTNERS MEDICARE CHOICE
8566000156058OTHERNORTH CAROLINATRICARE STANDARD, NON NWK
9DF8926OTHERNORTH CAROLINARAILROAD MEDICARE PTAN
10CC2854OTHERNORTH CAROLINARAILROAD MEDICARE
116006579OTHERNORTH CAROLINAMEDICAID, EFF 10/27/2008
126005328MEDICAIDNORTH CAROLINA
13019G5OTHERNORTH CAROLINABCBSNC
14355573OTHERNORTH CAROLINAMAMSI

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: 5/5/2024

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