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CARDINAL CLINIC L.L.C. NPI 1700967395


NPI Information

NPI: 1700967395
Provider Name: CARDINAL CLINIC L.L.C.
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
1540 PURDUE DR STE 200
FAYETTEVILLE, NC
ZIP 28303
Phone: (910) 867-8889
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CARDINAL CLINIC L.L.C. is a counselor in Fayetteville, NC. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. CARDINAL CLINIC L.L.C. NPI is 1700967395. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1540 PURDUE DR STE 200
FAYETTEVILLE, NC
ZIP 28303-510
Phone: (910) 867-8889
Fax: (910) 487-3061

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 10/18/2006 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
1101YM0800XCounselorMental HealthNo
2101YP2500XCounselorProfessionalNo
3103T00000XPsychologistNo
4104100000XSocial WorkerNo
51041C0700XSocial WorkerClinicalNo
6106H00000XMarriage & Family TherapistNo
72084P0800XPsychiatry & NeurologyPsychiatryNo
82084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
9101Y00000XCounselorYes

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
16005134MEDICAIDNORTH CAROLINA
21634MEDICARE PINNORTH CAROLINA
36005172MEDICAIDNORTH 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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