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General NPI Number Information
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NPI Number | 1508152711
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Entity Type | Organization
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Legal Business Name | CAROLINA BEHAVIORAL HEALTH INNOVATIONS, PLLC
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Dates
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Enumeration Date | 06/26/2011
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Last Update Date | 06/26/2011
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Provider Practice Location Address
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Address Line | 2129 S GLENBURNIE RD
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City | NEW BERN
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State | NC
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Zip | 28562-5267
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Country | US
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Telephone | 864-353-9939
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Fax |
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Provider Business Mailing Address
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Address Line | 111 MOM LN
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City | NEW BERN
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State | NC
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Zip | 28562-5702
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Country | US
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Telephone | 864-353-9939
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | AMY D JAMES
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Credential | PSYD
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Telephone | 864-353-9939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3997
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License Number State | NC
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