PRODIGIOUS HEALTH SERVICES LLC NPI 1720389182

NPI Information

  • NPI: 1720389182
  • Provider Name: PRODIGIOUS HEALTH SERVICES, LLC
  • Classification: Counselor - 101Y00000X
  • Entity Type: Organization
  • Address: 210 N MAIN ST
    ROXBORO, NC
    ZIP 27573
  • Phone: (252) 433-0300

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NPI Details

PRODIGIOUS HEALTH SERVICES, LLC is a counselor in Roxboro, 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. PRODIGIOUS HEALTH SERVICES, LLC NPI is 1720389182. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

210 N MAIN ST
ROXBORO, NC
ZIP 27573-325
Phone: (252) 433-0300
Fax: (252) 433-8054

The provider's authorized official is Bobby Faison .
The authorized official title is President and has the following contact phone number (252) 433-0300.

The enumeration date for this NPI number is 11/16/2010 and was last updated on 11/16/2010.

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
1101Y00000XCounselor875NORTH CAROLINAYes

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: 11/21/2025

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