MS. VICKIE M PERSAUD (NPI# 1174042907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174042907 |
| Entity Type | Individual |
| Full Name | MS. VICKIE M PERSAUD |
| Practice Address |
605 Thomas Nelson Street Colerain NC 27924-0134 |
| Mailing Address |
Po Box 134 Colerain NC 27924-0134 |
| Practice Telephone | 1252642534 |
| Practice Fax Number | 2526425300 |
| Mailing Telephone | 2526425345 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2020-03-05 |
| NPI Deactivation Date | 05/19/2019 |
| NPI Reactivation Date | 2020-02-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
605 THOMAS NELSON STREET, |
| City | COLERAIN |
| State | NC |
| Zip Code | 27924-0134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861515918 | Barbara Jean Davenport | Lodging | 116 Chowan Shores Drive, Colerain, NC 27924 | 2007-04-06 |
| 1649352998 | Colerain Rescue Squad Inc | Ambulance | 110 Winton St, Colerain, NC 27924 | 2006-10-19 |
| 1568951986 | Tonya C Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-05-02 |
| 1275027294 | The Home Place | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-06-22 |
| 1649764762 | Tonya Clark Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-06-21 |
| 1619523651 | Eathelda Caldwell | Technician | 1008 Perrytown Rd, Colerain, NC 27924-8953 | 2019-08-15 |
| 1790851004 | Roanoke Chowan Community Health Center, Inc | Clinic/Center | 109 W River St, Colerain, NC 27924-9006 | 2006-11-28 |
| 1811400203 | Roanoke Chowan Community Health Center Inc | Pharmacy | 109 W River St, Colerain, NC 27924-9006 | 2017-11-08 |
| 1720518574 | Roanoke Chowan Community Health Center Inc | Pharmacy | 109 W River St, Colerain, NC 27924-9006 | 2017-06-14 |
| 1053680892 | Chrystie Lee Stowe | Nurse Practitioner | 109 W River St, Colerain, NC 27924-9006 | 2011-12-23 |
| Find all providers in zip 27924 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, 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. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477932150 | Life Design Services, Inc. | Community/Behavioral Health | 837 Meadow Rd, Colerain, NC 27924-9199 | 2015-05-27 |
| 1366575268 | New Horizons Community Support Services, Inc. | Community/Behavioral Health | 126 Nc Highway 42, Colerain, NC 27924-9018 | 2007-03-13 |
| 1730374588 | New Horizons Community Support Services, Inc. | Community/Behavioral Health | 126 Nc Highway 42, Colerain, NC 27924-9018 | 2007-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121438 | Curtis Wayne Royal | Community/Behavioral Health | 1407 Groveland Trl, Greensboro, NC 27407-5061 | 2020-10-09 |
| 1578178588 | Emmanuel Homecare, Inc. | Community/Behavioral Health | 12551 Hashanli Pl, Matthews, NC 28105-3401 | 2020-09-15 |
| 1336753284 | Transformation Health Services Inc. | Community/Behavioral Health | 2023 Connonade Dr, Waxhaw, NC 28173-0109 | 2020-09-08 |
| 1053925099 | Essential Pathways Counseling and Consulting, Pllc | Community/Behavioral Health | 5009 Beatties Ford Rd Ste 107-274, Charlotte, NC 28216-2859 | 2020-09-08 |
| 1720692833 | Tgh Phase 2 | Community/Behavioral Health | 1121 Old Concord Rd Ste 14, Salisbury, NC 28146-1473 | 2020-09-04 |
| 1669086948 | October Road, Inc. | Community/Behavioral Health | 1304 Plaza Dr Ste 2312, Burlington, NC 27215-7165 | 2020-09-03 |
| 1225640188 | Flovi of Nc Inc. | Community/Behavioral Health | 1916 Sunset Ave, Rocky Mount, NC 27804-2520 | 2020-08-20 |
| 1275145658 | Next Level Counseling, Pllc | Community/Behavioral Health | Tele-therapy Only, Cary, NC 27511 | 2020-08-18 |
| 1023628872 | Jonathan Mccrary | Community/Behavioral Health | 5745 Bramblegate Rd Unit A, Greensboro, NC 27409-3019 | 2020-08-06 |
| 1841809746 | Ryan's Place, LLC | Community/Behavioral Health | 6000 Fairview Rd Ste 1259, Charlotte, NC 28210-2224 | 2020-07-27 |
| 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.