SELF-FULL PSYCHOTHERAPY, PC (NPI# 1710126412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710126412 |
| Entity Type | Organization |
| Organization Name | SELF-FULL PSYCHOTHERAPY, PC |
| Practice Address |
106 Oakley Ave Suite 300 Pineville NC 28134-8620 |
| Practice Telephone | 7045763635 |
| Practice Fax Number | 7048895649 |
| Mailing Telephone | 7045763635 |
| Mailing Fax Number | 7048895649 |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |
| Authorized Official Name | MS. DOROTHY CHRISTIN LUKE (OWNER/PRESIDENT) |
| Authorized Official Telephone | 7045763635 |
| Authorized Official Credential | MSW, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | C004450 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6002779 | 05 |
| Street Address |
106 OAKLEY AVE SUITE 300 |
| City | PINEVILLE |
| State | NC |
| Zip Code | 28134-8620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316959380 | Inez Marie Serventi | Counselor | 106 Oakley Ave, Suite 300, Pineville, NC 28134-8619 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144682873 | Mosaic Group, LLC | Community/Behavioral Health | 600 Towne Centre Blvd, Suite 403, Pineville, NC 28134 | 2016-03-22 |
| 1447545298 | Sunanda H Lachake | Pharmacist | 9101 Matthews-pineville Rd, Pineville, NC 28134 | 2011-06-09 |
| 1659663029 | Focal Point Chiropractic Health Center Pllc | Chiropractor | 103 Dover St., Pineville, NC 28134 | 2011-05-04 |
| 1649403577 | Chinyere Genevive Okam | Pharmacist | 11805 Southcrest Lane, Pineville, NC 28134 | 2009-08-26 |
| 1063649010 | Irene N/a D'alessandris | Community Health Worker | 1010 Lake View Dr., Pineville Rehab, Pineville, NC 28134 | 2009-06-17 |
| 1689827487 | Five Star Quality Care- North Carolina, LLC | Alzheimer Center (Dementia Center) | 13180 Dorman Road, Pineville, NC 28134 | 2008-10-24 |
| 1598940637 | Janice S Blocker | Physical Therapy Assistant | 1010 Lakeview Drive, Pineville, NC 28134 | 2008-01-08 |
| 1760603195 | Alisha S Richmond | Speech-Language Pathologist | 10624 Lighthouse Lane, Pineville, NC 28134 | 2007-05-02 |
| 1043374655 | Tiffany Howard | Counselor | 12438 Woodside Falls Road, Pineville, NC 28134 | 2006-12-20 |
| 1003919192 | Joey Scott Hartsell | Chiropractor | 216 Main St., Pineville, NC 28134 | 2006-09-06 |
| Find all providers in zip 28134 | ||||
| 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 |
|---|---|---|---|---|
| 1215471180 | Bayou Mental Health Services,llc | Community/Behavioral Health | 818 Maint St Ste A, Pineville, LA 71360 | 2016-12-13 |
| 1144682873 | Mosaic Group, LLC | Community/Behavioral Health | 600 Towne Centre Blvd, Suite 403, Pineville, NC 28134 | 2016-03-22 |
| 1861895740 | Tonga's Counseling and Assessment Services | Community/Behavioral Health | 109 Armstrong St, Pineville, LA 71360-6610 | 2014-10-06 |
| 1124159389 | Cenla Case Management, LLC | Community/Behavioral Health | 5808 Highway 28 E, Pineville, LA 71360-7704 | 2007-03-08 |
| 1518306000 | Bayou Mental Health Services, LLC. | Community/Behavioral Health | 818 Main St, Pineville, LA 71360-6409 | 2013-06-18 |
| 1780942565 | La Federation of Families | Community/Behavioral Health | 802 Main St, Pineville, LA 71360-6406 | 2012-04-30 |
| 1588937098 | Childrens Advocacy Center of Bell County | Community/Behavioral Health | 313 S Cherry St, Pineville, KY 40977-1724 | 2012-02-14 |
| 1427365600 | Shamrock Street Pharmacy | Community/Behavioral Health | 242 West Shamrock Street, Unit 2, Room 120, Pineville, LA 71360-6439 | 2010-09-09 |
| 1124201793 | Freedom Counseling Center Inc | Community/Behavioral Health | 2801 Donahue Ferry Rd, Pineville, LA 71360-4513 | 2007-12-06 |
| 1245458991 | Pinecrest Developmental Center | Community/Behavioral Health | 2969 Highway 28 E, Pineville, LA 71360-5716 | 2007-04-20 |
| Find all providers in PINEVILLE | ||||
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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.