Healthcare Provider Details

I. General information

NPI: 1538344049
Provider Name (Legal Business Name): NAVARRE BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 SAVANNAH RIDGE RD SUITE 111
HOLLY SPRINGS NC
27540
US

IV. Provider business mailing address

PO BOX 1015
HOLLY SPRINGS NC
27540-1015
US

V. Phone/Fax

Practice location:
  • Phone: 919-884-9033
  • Fax: 919-884-9033
Mailing address:
  • Phone: 919-884-9033
  • Fax: 888-242-6653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberSW8804
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC004448
License Number StateNC

VIII. Authorized Official

Name: MRS. NICOLE S. HAMMONDS
Title or Position: OWNER
Credential: LCSW
Phone: 919-884-9033