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SUPPORT INCORPORATED NPI 1780974253


NPI Information

NPI: 1780974253
Provider Name: SUPPORT INCORPORATED
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
708 S CHESTNUT ST
GASTONIA, NC
ZIP 28054
Phone: (704) 865-3525
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SUPPORT INCORPORATED is a community behavioral health in Gastonia, 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. SUPPORT INCORPORATED NPI is 1780974253. The provider is registered as an organization entity type.

The provider's business location address is:

708 S CHESTNUT ST
GASTONIA, NC
ZIP 28054-548
Phone: (704) 865-3525
Fax: (704) 865-3520

The provider's authorized official is Josh Martin .
The authorized official title is Executive Director and has the following contact phone number (704) 865-3529.

The enumeration date for this NPI number is 4/18/2011 and was last updated on 12/30/2015.


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
1261QP2300XClinic/CenterPrimary CareNo
2261QM1300XClinic/CenterMulti-SpecialtyNo
3101YA0400XCounselorAddiction (Substance Use Disorder)No
4101YM0800XCounselorMental HealthNo
5101YP2500XCounselorProfessionalNo
6103T00000XPsychologistNo
72084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
8363L00000XNurse PractitionerNo
9363LF0000XNurse PractitionerFamilyNo
10363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
11363A00000XPhysician AssistantNo
121041C0700XSocial WorkerClinicalNo
13251S00000XCommunity/Behavioral HealthMHL-036-292NORTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15918314MEDICAIDNORTH CAROLINA
28303341MEDICAIDNORTH CAROLINA
36005063MEDICAIDNORTH CAROLINA
42347932MEDICARE PINNORTH CAROLINA
5016V4OTHERNORTH CAROLINABCBS

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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