COMMUNITY INNOVATIONS, INC. (NPI# 1265708549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265708549 |
| Entity Type | Organization |
| Organization Name | COMMUNITY INNOVATIONS, INC. |
| Practice Address |
3972 Business 17 E Ste C Bolivia NC 28422-9030 |
| Mailing Address |
3210 Fairhill Dr Raleigh NC 27612-3215 |
| Practice Telephone | 9102538700 |
| Practice Fax Number | 9102538755 |
| Mailing Telephone | 9192560824 |
| Mailing Fax Number | 9192560833 |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-10-08 |
| Authorized Official Name | HAROLD ERNEST JONES JR. (SR. VICE PRESIDENT) |
| Authorized Official Telephone | 9192560824 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154645554 | Community Innovations, Inc. | Community/Behavioral Health | 805 Wilson St, Whiteville, NC 28472-4713 | 2010-03-15 |
| 1275740821 | Community Innovations, Inc. | Community/Behavioral Health | 410 Peanut Plant Rd, Elizabethtown, NC 28337-9482 | 2007-05-16 |
| 1255548863 | Community Innovations, Inc. | Community/Behavioral Health | 1503 S Glen Burnie Rd, New Bern, NC 28562-1503 | 2007-05-16 |
| 1780756056 | Community Innovations, Inc. | Case Management | 1503 S Glen Burnie Road, New Bern, NC 28562-1503 | 2006-11-14 |
| 1740350446 | Community Innovations, Inc. | Case Manager/Care Coordinator | 1104 W. Broad St, Elizabethtown, NC 28337 | 2006-11-09 |
| 1679643373 | Community Innovations, Inc. | Counselor | 1781 South Main Street, Laurinburg, NC 28352 | 2006-11-09 |
| 1275614893 | Community Innovations, Inc. | Case Management | 410 Peanut Plant Road, Elizabethtown, NC 28337-7103 | 2006-10-18 |
| 1932298262 | Community Innovations, Inc. | Case Management | 118 E Walter St, Whiteville, NC 28472-4142 | 2006-10-12 |
| 1972692960 | Community Innovations, Inc. | Case Management | 704 Progress Pl, Ste B, Laurinburg, NC 28352-5545 | 2006-10-11 |
| 1164798518 | Community Innovations, Inc. | Psychiatry & Neurology | 3972 Business 17 E, Ste C, Bolivia, NC 28422-9030 | 2012-03-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | COMMUNITY INNOVATIONS, INC. | 120 Bloomingdale Rd #100, White Plains, Ny 10605 |
| Street Address |
3972 BUSINESS 17 E STE C |
| City | BOLIVIA |
| State | NC |
| Zip Code | 28422-9030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396010047 | Saguaro Group, LLC | Community/Behavioral Health | 3972 Business 17 E, Ste C, Bolivia, NC 28422-9030 | 2012-03-14 |
| 1164798518 | Community Innovations, Inc. | Psychiatry & Neurology | 3972 Business 17 E, Ste C, Bolivia, NC 28422-9030 | 2012-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616596 | Riccobene and Associates Xli, Dds, P.a. | Dentist | 211 Midway Commons, Suite 116, Bolivia, NC 28422 | 2020-10-15 |
| 1962029942 | Novant Medical Group. Inc. | Family Medicine | 150 College Rd Ne, Bolivia, NC 28422 | 2020-06-25 |
| 1033730866 | Tamika Jocinda Yushaw | Social Worker | 25 Courthouse Drive Ne, Bolivia, NC 28422 | 2020-05-04 |
| 1821648882 | Daniel Burk | Physician Assistant | 584 Hospital Drive Suite A, Bolivia, NC 28422 | 2019-09-12 |
| 1427452283 | East Carolina University School of Dental Medicine-brunswick | Dentist | 100 Brunswick Medical Center Parkway, Bolivia, NC 28422 | 2014-10-22 |
| 1689080632 | Cecilia Liu | Dentist | 3071 Southport Supply Rd Se, Bolivia, NC 28422 | 2014-07-09 |
| 1922372341 | Lorie L Harding | Physician Assistant | 584 Hospital Dr Ne Unit C, Bolivia, NC 28422 | 2012-03-02 |
| 1902095383 | Cayce Mccall Patterson | Physical Therapist | 35 Referendum Dr, Brunswick County Schools, Bolivia, NC 28422 | 2007-10-22 |
| 1235288622 | Susan Beth Kam | Psychologist | 63 Stamp Act Drive, Bolivia, NC 28422 | 2007-01-09 |
| 1578632477 | Sarah E Oxford | Case Manager/Care Coordinator | 63 Stamp Act Dr, Building M, Bolivia, NC 28422 | 2006-11-06 |
| Find all providers in zip 28422 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033730866 | Tamika Jocinda Yushaw | Social Worker | 25 Courthouse Drive Ne, Bolivia, NC 28422 | 2020-05-04 |
| 1407207657 | Heather Howard | Social Worker | 10 Referendum Dr Ne, Bolivia, NC 28422-7579 | 2016-06-29 |
| 1114086329 | Thomas B. Kiggins | Social Worker | 639 Creekway Cir Se, Bolivia, NC 28422-8266 | 2006-12-06 |
| 1407373236 | Lori Cochard | Social Worker | 4036 Business 17 E, Bolivia, NC 28422-8644 | 2017-08-23 |
| 1497947741 | Raven Grace Lefebvre | Social Worker | 63 Stamp Act Dr, Bolivia, NC 28422 | 2007-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881887 | Lillian Jean Goodkind | Social Worker | 68 N French Broad Ave, Asheville, NC 28801-2600 | 2020-11-05 |
| 1770184657 | Delia Hearon | Social Worker | 100 Village Circle Way Apt 216, Durham, NC 27713-6131 | 2020-11-05 |
| 1346841459 | Mickaella Ann Moser | Social Worker | 3030 Adams Blvd Apt 13, Greenville, NC 27858-4840 | 2020-11-04 |
| 1750981346 | Tarsha M. Hall | Social Worker | 645 Spruce Garden Ct, Rural Hall, NC 27045-9159 | 2020-11-01 |
| 1184224727 | Kwanza Suzanne Winn | Social Worker | 2510 Hope Way Ln Apt 202, Charlotte, NC 28262-6955 | 2020-10-30 |
| 1164022570 | Directional Care Community Services LLC. | Social Worker | 6220 Sid Crane Dr, Charlotte, NC 28216-7684 | 2020-10-27 |
| 1295335602 | Macie Whitlow | Social Worker | 1825 W City Dr Ste A&b, Elizabeth City, NC 27909-9675 | 2020-10-27 |
| 1689274011 | Ashleigh Weckesser | Social Worker | 216 Reams Dr, Middlesex, NC 27557-8650 | 2020-10-26 |
| 1750980256 | Victoria Snow | Social Worker | 504 E Pettigrew St Apt 449, Durham, NC 27701-3888 | 2020-10-26 |
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 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.