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THERAPEUTIC SPECIALTIES OF NORTH CAROLINA PLLC NPI 1720381395


NPI Information

NPI: 1720381395
Provider Name: THERAPEUTIC SPECIALTIES OF NORTH CAROLINA, PLLC

Former Legal Business Name: HENDERSON PSYCHOLOGICAL SERVICES, PLLC

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
104 MARKET ST
HENDERSON, NC
ZIP 27537
Phone: (252) 431-4418
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THERAPEUTIC SPECIALTIES OF NORTH CAROLINA, PLLC is a community behavioral health in Henderson, 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. THERAPEUTIC SPECIALTIES OF NORTH CAROLINA, PLLC NPI is 1720381395. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Henderson Psychological Services, Pllc.

The provider's business location address is:

104 MARKET ST
HENDERSON, NC
ZIP 27537-751
Phone: (252) 431-4418
Fax: (252) 572-2418

The provider's authorized official is Tammy S Juntunen .
The authorized official title is Co-owner and has the following contact phone number (252) 431-4418.

The enumeration date for this NPI number is 12/21/2010 and was last updated on 9/1/2023.


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
1235Z00000XSpeech-Language PathologistNo
2251S00000XCommunity/Behavioral Health2348NORTH CAROLINANo
3101YP2500XCounselorProfessionalNo
4103T00000XPsychologistNo
5101YM0800XCounselorMental HealthNo
6251S00000XCommunity/Behavioral Health2332NORTH 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
16107348MEDICAIDNORTH CAROLINA
26107074MEDICAIDNORTH 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: 5/5/2024

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