SOUTHEASTERN PSYCHOLOGICAL SERVICES (NPI# 1952301079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952301079 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN PSYCHOLOGICAL SERVICES |
| Practice Address |
302 N Main St Fairmont NC 28340-1730 |
| Mailing Address |
302 N Main St Po Box 369 Fairmont NC 28340-1730 |
| Practice Telephone | 9106286718 |
| Practice Fax Number | 9106286719 |
| Mailing Telephone | 9106286718 |
| Mailing Fax Number | 9106286719 |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. LINDA OLIVER-LINK (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 9106826718 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ========= | NC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 0384M | 01 |
| NC | 6005435 | 05 | |
| NC | BCBS | 1318H | 01 |
| Street Address |
302 N MAIN ST |
| City | FAIRMONT |
| State | NC |
| Zip Code | 28340-1730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265703201 | The Dream Academy, Inc. | Case Management | 302 N Main St, Fairmont, NC 28340-1730 | 2012-01-23 |
| 1700164613 | Therapeutic Behavioral Healthcare Services, LLC | Home Health | 302 N Main St, Fairmont, NC 28340-1730 | 2011-07-26 |
| 1821313958 | Anthony Pittman | Counselor | 302 N Main St, Fairmont, NC 28340-1730 | 2010-03-31 |
| 1689906521 | Therapeutic Behavioral Healthcare Services | Home Health | 302 N Main St, Fairmont, NC 28340-1730 | 2010-02-03 |
| 1033441977 | Therapeutic Behavioral Healthcare Services | Counselor | 302 N Main St, Fairmont, NC 28340-1730 | 2010-02-03 |
| 1104158047 | Therapeutic Behavioral Healthcare Services | Day Training, Developmentally Disabled Services | 302 N Main St, Fairmont, NC 28340-1730 | 2010-02-03 |
| 1780916627 | Therapeutic Behavioral Healthcare Services | Foster Care Agency | 302 N Main St, Fairmont, NC 28340-1730 | 2010-02-03 |
| 1891026886 | Therapeutic Behavioral Healthcare Services | Community/Behavioral Health | 302 N Main St, Fairmont, NC 28340-1730 | 2010-01-15 |
| 1508990979 | Melissa Johanna Spencer | Specialist | 302 N Main St, Fairmont, NC 28340-1730 | 2007-03-15 |
| 1669547204 | Mary Lewis Hardin | Psychologist | 302 N Main St, Fairmont, NC 28340-1730 | 2006-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023250347 | Independent Community-based Services LLC | Home Health | 107 N Morro St., Fairmont, NC 28340 | 2009-04-01 |
| 1801960083 | Greenbrier Ltc Inc | Assisted Living Facility | 703 South Walnut St, Fairmont, NC 28340 | 2006-11-20 |
| 1275969487 | Robeson Health Care Corporation | Pharmacy | 1212 S Walnut St, Fairmont, NC 28340 | 2013-09-19 |
| 1033221130 | Jeffrey Lemont Hunter | Counselor | 314 S Main St, Fairmont, NC 28340 | 2006-08-31 |
| 1912924648 | Danny Cox | Durable Medical Equipment & Medical Supplies | 234 S Main St, Homecare Medical Products, Fairmont, NC 28340 | 2006-07-17 |
| 1417914722 | Robeson Health Care Corporation | Counselor | 1212 S Walnut St, Fairmont, NC 28340 | 2006-04-28 |
| 1952768426 | Latanya Breeden | Adult Companion | 609 Martin Luther King Dr, Fairmont, NC 28340-1311 | 2016-01-28 |
| 1033252440 | Stephens Outreach Center, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 608a Martin Luther King Dr, Fairmont, NC 28340-1312 | 2007-02-15 |
| 1629027842 | James Clifton Herring Jr. | Optometrist | 1516 Alexander St, Fairmont, NC 28340-1406 | 2006-05-06 |
| 1225142391 | Sean Brian Woken | Chiropractor | 208 Iona St, Fairmont, NC 28340-1616 | 2006-08-18 |
| Find all providers in zip 28340 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205112992 | Coall Inc | Specialist | 74 Roxbury Rd, Fairmont, WV 26554-8223 | 2011-10-26 |
| 1942493812 | Frederick Manalo Alcantara | Specialist | 2048 Vip Way, Fairmont, WV 26554 | 2007-08-23 |
| 1801094362 | Helen Hunt II | Specialist | 1909 Horne Camp Rd, Fairmont, NC 28340-8787 | 2007-07-06 |
| 1134235724 | Subbareddy Kurapati | Specialist | 11 Pheasant Dr, Fairmont, WV 26554-1246 | 2006-08-23 |
| 1750343125 | Fairmont General Hospital, Inc. | Specialist | 1325 Locust Ave, Fairmont, WV 26554-1435 | 2006-04-03 |
| 1447239876 | Planned Parenthood Minnesota, North Dakota, South Dakota | Specialist | 206 E 3rd St, Fairmont, MN 56031-2828 | 2006-01-13 |
| 1396736252 | Linking Services | Specialist | 314 S Main St, Fairmont, NC 28340-1906 | 2005-10-31 |
| 1811987795 | Peggy Sue Mason | Specialist | 835 Johnson St, Fairmont, MN 56031-4523 | 2005-10-24 |
| 1427667476 | Brianna Farnsworth | Specialist | 207 Fairmont Ave, Fairmont, WV 26554-0168 | 2020-07-27 |
| 1497157127 | Alecto Healthcare Services Fairmont LLC | Specialist | 1325 Locust Ave, Fairmont, WV 26554-1435 | 2014-09-25 |
| Find all providers in FAIRMONT | ||||
Please comment or provide details below to improve the information on SOUTHEASTERN PSYCHOLOGICAL SERVICES.
| 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.