BEHAVIORAL HEALTH CENTER CMC RANDOLPH (NPI# 1821278664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821278664 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL HEALTH CENTER CMC RANDOLPH |
| Other Organization Name | DIAGNOSTIC ASSESSMENT SERVICES/ACCESS |
| Practice Address |
501 Billingsley Road Behavioral Health Center Cmc Randolph Charlotte NC 28211-1009 |
| Practice Telephone | 7043366570 |
| Practice Fax Number | 7043363623 |
| Mailing Telephone | 7043582700 |
| Mailing Fax Number | 7043582938 |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2007-11-09 |
| Authorized Official Name | THOMAS E. GETTELMAN (ASSISTANT VICE PRESIDENT) |
| Authorized Official Telephone | 7044442406 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
H0071 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300443G | 05 |
| Other Name | Type Code |
|---|---|
| Diagnostic Assessment Services/ACCESS | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497952709 | Behavioral Health Center Cmc Randolph | Clinic/Center | 1216 N Tryon St, Behavioral Health Center Cmc Randolph, Charlotte, NC 28206-3256 | 2007-06-29 |
| 1306043658 | Behavioral Health Center Cmc Randolph | Clinic/Center | 1216 N Tryon Street, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2007-06-29 |
| 1649450487 | Behavioral Health Center Cmc Randolph | Clinic/Center | 330 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2007-11-09 |
| 1093995839 | Behavioral Health Center Cmc Randolph | Clinic/Center | 330 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-5055 | 2007-11-09 |
| 1710167564 | Behavioral Health Center Cmc Randolph | Clinic/Center | 330 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-5055 | 2007-11-09 |
| 1508055336 | Behavioral Health Center Cmc Randolph | Clinic/Center | 330 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2007-10-17 |
| 1144419979 | Behavioral Health Center Cmc Randolph | Clinic/Center | 330 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-5055 | 2007-10-17 |
| 1104015023 | Behavioral Health Center Cmc Randolph | Clinic/Center | Behavioral Health Center Cmc Randolph, 501 Billingsley Road, Charlotte, NC 28211-1009 | 2007-10-16 |
| Street Address |
501 BILLINGSLEY ROAD BEHAVIORAL HEALTH CENTER CMC RANDOLPH |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316970502 | Misty L. Collier | Psychologist | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2006-07-09 |
| 1982034567 | Kathleen Kelly Mezwicki | Social Worker | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2013-11-19 |
| 1275804791 | Jacqueline W. Shields | Social Worker | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2012-01-13 |
| 1821395625 | Allan T. Howe | Social Worker | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2011-02-15 |
| 1669792503 | Carolinas Medical Center | Clinic/Center | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2010-06-02 |
| 1093958217 | Claire Nicole Jones | Social Worker | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2009-04-17 |
| 1104061993 | John Mark Jackson | Counselor | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2008-12-08 |
| 1972768661 | Carolinas Medical Center | Community/Behavioral Health | 501 Billingsley Road, Chs Behavioral Health Charlotte Administration, Charlotte, NC 28211-1009 | 2008-07-23 |
| 1174788897 | Carolinas Medical Center | Community/Behavioral Health | 501 Billingsley Road, Chs Behavioral Health Charlotte Administration, Charlotte, NC 28211-1009 | 2008-07-22 |
| 1124281290 | Carolinas Medical Center | Clinic/Center | 501 Billingsley Road, Behavioral Health Center Cmc Randolph, Charlotte, NC 28211-1009 | 2008-07-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1598316770 | Renaissance Healthcare Group Raleigh, LLC | Clinic/Center | 7300 Carmel Executive Park Dr Ste 100, Charlotte, NC 28226-1307 | 2019-09-27 |
| 1255981627 | Each One Teach Two | Clinic/Center | 401 Hawthorne Ln Ste 110-224, Charlotte, NC 28204-2484 | 2019-09-17 |
| 1073081014 | Inspired Hope | Clinic/Center | 7833 Calibre Crossing Dr Apt 205, Charlotte, NC 28227-6780 | 2018-11-07 |
| 1376038224 | Adams Counseling Service Pllc | Clinic/Center | 3623 Latrobe Dr Ste 110a-1, Charlotte, NC 28211-4864 | 2018-06-23 |
| 1194222174 | Dedicated 2 Liberating, LLC | Clinic/Center | 5415 Airport Dr, Charlotte, NC 28208-5733 | 2018-04-06 |
| 1033612825 | Behavioral Health Intervention Center, LLC | Clinic/Center | 8401 Medical Plaza Dr Ste 120, Charlotte, NC 28262-9769 | 2018-03-17 |
| 1609313311 | Mary A Martin Np Bc | Clinic/Center | 10430 Haddington Dr Nw, Charlotte, NC 28269-6955 | 2017-01-20 |
| 1114297041 | Scn Psyhological and Consulting Services LLC | Clinic/Center | 6729 Fairview Rd Ste D, Charlotte, NC 28210-0127 | 2012-01-10 |
| 1750546347 | Carolinas Medical Center | Clinic/Center | 1216 North Tryon Street, Behavioral Health Center Cmc Randolph, Charlotte, NC 28206-3256 | 2008-07-23 |
| 1508023193 | Tammaria Lucilia Boyd | Clinic/Center | 1517 N Alexander St, Charlotte, NC 28205-2640 | 2008-05-21 |
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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.