MEDICARE: PINNACLE FAMILY SERVICES OF NORTH CAROLINA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1376910976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE FAMILY SERVICES OF NORTH CAROLINA LLC

Provider Business Mailing Address
First Line	:	3117 POPLARWOOD CT STE 207
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-1040
Country	:	US
Telephone Number	:	919-790-8580
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 WAYNE MEMORIAL DR
Second Line	:	SUITES A & B
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-2255
Country	:	US
Telephone Number	:	919-734-0759
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PRESTON SCOTT MARTIN
Credential	:
Telephone Number	:	919-790-8580

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	07/25/2019

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