NEIL BLUE (NPI# 1679777494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679777494 |
| Entity Type | Individual |
| Full Name | NEIL BLUE |
| Credential | LPC |
| Practice Address |
4276 Legend Ave Suite C Fayetteville NC 28303-1965 |
| Practice Telephone | 9108670035 |
| Mailing Telephone | 9108670035 |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2008-07-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6103649 | 05 |
| Street Address |
4276 LEGEND AVE SUITE C |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-1965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790186765 | Shekeema Schultz | Counselor | 4276 Legend Ave, Fayetteville, NC 28303-3497 | 2014-09-10 |
| 1558646661 | Ashley Poole | Counselor | 4276 Legend Ave, Fayetteville, NC 28303-1965 | 2011-10-20 |
| 1801113899 | James Anthony Vales Sr. | Social Worker | 4276 Legend Ave, Fayetteville, NC 28303-1965 | 2010-04-29 |
| 1578704466 | Evergreen Health Services, LLC | Clinic/Center | 4276 Legend Ave, Fayetteville, NC 28303-1965 | 2009-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619583432 | Don Del-raye Jones | Counselor | 521 Rempstone Ln, Fayetteville, NC 28311-5501 | 2020-09-17 |
| 1023628278 | Quadiedra Amos | Counselor | 3675 Fallstaff Dr, Fayetteville, NC 28306-9079 | 2020-08-03 |
| 1699385963 | William Jones | Counselor | 4250 Clinton Rd Ste 102, Fayetteville, NC 28312-8517 | 2020-08-03 |
| 1952919573 | Bianca Thomas | Counselor | 2713 Lake Club Dr, Fayetteville, NC 28304-5349 | 2020-07-20 |
| 1962029546 | Deanna Dale Dunn | Counselor | 767 W North St Ste 112, Fayetteville, AR 72701-1865 | 2020-06-30 |
| 1053937490 | Balance Ground Counseling LLC | Counselor | 240 Lofty Eagle Ln, Fayetteville, GA 30214-3531 | 2020-06-22 |
| 1659994010 | Martanika Michelle Smith | Counselor | 351 Wagoner Dr Ste 105, Fayetteville, NC 28303-4608 | 2020-05-20 |
| 1477188985 | Qiana Tamieka Gatling | Counselor | 4417 Briton Cir, Fayetteville, NC 28314-2401 | 2020-03-04 |
| 1467086496 | The Pair Center for Couples Counseling Pllc | Counselor | 5085 Morganton Road, Suite 300, Fayetteville, NC 28314 | 2020-02-28 |
| 1194359182 | Meredith Leigh Kimbrough | Counselor | 31 E Center St Ste 210, Fayetteville, AR 72701-5391 | 2020-02-27 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on NEIL BLUE.
| 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.