DR. MANIJEH BOUSTANI (NPI# 1134215031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134215031 |
| Entity Type | Individual |
| Full Name | DR. MANIJEH BOUSTANI |
| Credential | PH.D. |
| Practice Address |
2401 Wooten Blvd Sw Ste K Wilson NC 27893-4464 |
| Mailing Address |
608 Penncross Dr Raleigh NC 27610-2177 |
| Practice Telephone | 2522910735 |
| Practice Fax Number | 2522912890 |
| Mailing Telephone | 9196563589 |
| Mailing Fax Number | 9192430923 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2018-09-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1456 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 0416L | 01 |
| NC | 6000721 | 05 | |
| NC | 6000563 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 105 S Ellington St, Clayton, NC 275202305 | 9192430454 | 9192430923 |
| Street Address |
2401 WOOTEN BLVD SW STE K |
| City | WILSON |
| State | NC |
| Zip Code | 27893-4464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497780191 | Regan Lee Hannant | Social Worker | 2401 Wooten Blvd Sw Ste K, Wilson, NC 27893-4464 | 2006-07-11 |
| 1104179340 | Psychological Mobile Services, Pa | Psychologist | 2401 Wooten Blvd Sw Ste K, Wilson, NC 27893-4464 | 2012-10-25 |
| 1417235391 | Lynn Sauls Tyndall | Social Worker | 2401 Wooten Blvd Sw Ste K, Wilson, NC 27893 | 2011-07-27 |
| 1366744203 | James Eric Bailey | Counselor | 2401 Wooten Blvd Sw Ste K, Wilson, NC 27893 | 2010-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847524 | Graceland Student Services LLC | Early Intervention Provider Agency | 610 Fairview Ave., Wilson, NC 27893 | 2020-09-30 |
| 1508477894 | Evan Michael Abatiell | Specialist/Technologist | 400 Atlantic Christian E West Ne, Wilson, NC 27893 | 2020-08-11 |
| 1679100606 | Newgreen Inhomecare Group Inc | Registered Nurse | 121 Nast Street N, Wilson, NC 27893 | 2020-03-27 |
| 1942772983 | Open Water Medical, Pa | Clinic/Center | 4008 Nc-42, Wilson, NC 27893 | 2018-12-31 |
| 1679043244 | Madison Rose Propst | Social Worker | 2416 Bedgood, Wilson, NC 27893 | 2018-11-27 |
| 1104396753 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 2500 Horton Blvd, Wilson, NC 27893 | 2018-11-27 |
| 1528545498 | North Carolina In-home Partner-viii, LLC | Home Health | 1901 Tarboro St Sw Ste 304, Wilson, NC 27893 | 2018-07-24 |
| 1518478957 | Home Away From Home, Inc. | In Home Supportive Care | 1723 Meadowbrook Lane W., Wilson, NC 27893 | 2017-10-12 |
| 1942721295 | Sandra Susan Blazek | Social Worker | 608 Nash Street Nw, Wilson, NC 27893 | 2017-06-27 |
| 1700306297 | Kimberly Denton Almkuist | Nurse Practitioner | Wilson County Health Department, 1801 Glendale Dr. Sw, Wilson, NC 27893 | 2017-06-26 |
| Find all providers in zip 27893 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528186582 | Eddie Stuart Tessnear | Psychologist | 2403 Wooten Blvd Sw, Suite E, Wilson, NC 27893-4463 | 2007-03-27 |
| 1760551774 | Mary Susanne Miller | Psychologist | N15019 Hannahville B1 Rd., Wilson, MI 49896 | 2006-11-06 |
| 1740252378 | Paul J Speziale | Psychologist | 2401 Wooten Blvd Sw, Suite K, Wilson, NC 27893-4464 | 2006-02-07 |
| 1063414423 | Elizabeth Botzer | Psychologist | 4373 Chestnut Rd, Wilson, NY 14172 | 2005-08-15 |
| 1104179340 | Psychological Mobile Services, Pa | Psychologist | 2401 Wooten Blvd Sw Ste K, Wilson, NC 27893-4464 | 2012-10-25 |
| 1104044619 | Eddie Tessnear | Psychologist | 2403 Wooten Blvd Sw, Suite E, Wilson, NC 27893-4463 | 2007-04-22 |
| 1811013790 | Steven N Hannant | Psychologist | 2401 Wooten Blvd Sw, Suite K, Wilson, NC 27893-4464 | 2007-03-22 |
| 1235204223 | Cameron Kirkland Collins | Psychologist | 2261 Nash St Nw, Wilson, NC 27896 | 2006-11-22 |
| 1396844239 | Robert D Gregory | Psychologist | 2401 Wooten Blvd Sw, Suite K, Wilson, NC 27893-4464 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194338749 | Akaosa Onuma Eleanya | Psychologist | 4413 Wedgewood Dr, Raleigh, NC 27604-5098 | 2020-08-24 |
| 1720698939 | Blue Ridge Behavior Systems Inc | Psychologist | 16147 Lancaster Hwy Ste 110, Charlotte, NC 28277-4196 | 2020-08-03 |
| 1538778584 | Stephanie Goodson | Psychologist | 1638 Lookout Cir, Waxhaw, NC 28173-8085 | 2020-07-27 |
| 1205453388 | Gregory A Welikson, Phd, Pllc | Psychologist | 1334 Daventry Ct, Chapel Hill, NC 27517-9412 | 2020-07-06 |
| 1689297921 | David B Spano | Psychologist | 3205 N Mcdowell St, Charlotte, NC 28205-1552 | 2020-05-21 |
| 1174145338 | Matthew Charles Whited | Psychologist | Pass Clinic Rawl Building Room 311, East Carolina University, Greenville, NC 27858 | 2020-05-11 |
| 1952939811 | A4psychology, Pllc | Psychologist | 596 Executive Pl Ste 201, Fayetteville, NC 28305-5189 | 2020-03-27 |
| 1407487226 | James Francis Skane Jr. | Psychologist | 123 S 29th St, Wilmington, NC 28403-1223 | 2020-01-30 |
| 1932746294 | Lindsay Pulver | Psychologist | 3501 Sherbourne Ln, Greensboro, NC 27405-4964 | 2019-12-05 |
| 1164065827 | Whitney Beth Griffin | Psychologist | 2310 Stinson Drive Ncsu Dept of Psychology 640 Poe Hall, Raleigh, NC 27695-0001 | 2019-10-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.