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INTEGRATED BEHAVIORAL HEALTH MANAGEMENT NPI 1780033233


NPI Information

NPI: 1780033233
Provider Name: INTEGRATED BEHAVIORAL HEALTH MANAGEMENT
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 34D2173939

Address:
10320 MALLARD CREEK RD
SUITE 240
CHARLOTTE, NC
ZIP 28262
Phone: (704) 910-6142
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INTEGRATED BEHAVIORAL HEALTH MANAGEMENT is a community behavioral health in Charlotte, 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. INTEGRATED BEHAVIORAL HEALTH MANAGEMENT NPI is 1780033233. The provider is registered as an organization entity type.

The provider's business location address is:

10320 MALLARD CREEK RD
SUITE 240
CHARLOTTE, NC
ZIP 28262-208
Phone: (704) 910-6142

The provider's authorized official is Maryann Richardson .
The authorized official title is Director and has the following contact phone number (704) 910-6142.

The CLIA number assigned to this NPI record is 34D2173939 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/6/2016 and was last updated on 11/1/2016.


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
1261QM0850XClinic/CenterAdult Mental Health5004974NORTH CAROLINANo
2261QM0855XClinic/CenterAdolescent and Children Mental Health5004974NORTH CAROLINANo
3251B00000XCase Management5004974NORTH CAROLINANo
4261QP2300XClinic/CenterPrimary Care5004974NORTH CAROLINANo
5251S00000XCommunity/Behavioral Health5006630NORTH CAROLINAYes

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
1NC1285AMEDICARE UPINNORTH 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: 11/14/2023

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