Innovative Behavioral Health Services P.C.
Clinic/Center, Multi-Specialty in Creedmoor, NC. Organization (NPI-2).
NPI number1124367347
StatusActive
Last updated in NPPESFeb 23, 2022
Details
- NPI
- 1124367347
- Entity type
- Organization (NPI-2)
- Legal business name
- Innovative Behavioral Health Services P.C.
- Organization subpart
- No
- Enumeration date
- Feb 7, 2013
- Certification date
- Feb 23, 2022
- Last updated
- Feb 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
402 Main StCreedmoor, NC 27522
Phone 919-529-2474
Mailing address
Po Box 400Creedmoor, NC 27522-0400
Phone 919-529-2474
Other practice locations
1616 Evans Rd Ste 203
Cary, NC 27513-9653
Cary, NC 27513-9653
Phone 919-234-1321 · Fax 919-234-1327
Authorized official
Benjamin Joseph Mastridge
President
9195292474
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