SOUTH SHORE MENTAL HEALTH NPI 1851480891

NPI Information

NPI: 1851480891
Provider Name: SOUTH SHORE MENTAL HEALTH
Classification: Public Health or Welfare - 251K00000X
Entity Type: Organization
Address:
4820 SWANNS MILL DR
DURHAM, NC
ZIP 27704
Phone: (919) 323-0381
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SOUTH SHORE MENTAL HEALTH is a public health or welfare in Durham, NC. SOUTH SHORE MENTAL HEALTH NPI is 1851480891. The provider is registered as an organization entity type.

The provider's business location address is:

4820 SWANNS MILL DR
DURHAM, NC
ZIP 27704-492
Phone: (919) 323-0381

The provider's authorized official is Sonia Gooden-alexis .
The authorized official title is Self and has the following contact phone number (919) 323-0381.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 11/17/2008.

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
1	251K00000X	Public Health or Welfare		5736	MASSACHUSETTS	No
2	251K00000X	Public Health or Welfare		6748	NORTH CAROLINA	Yes

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
1	=========	MEDICARE UPIN	MASSACHUSETTS
2	S014759	MEDICAID	MASSACHUSETTS
3	Y 10241	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS	PROVIDERS NUMBER

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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