| A Fresh Start Behavioral Health Services, Pllc | |
|
2407 Grace Ave New Bern NC 28562-4416 | |
| (252) 414-9776 | |
| (252) 414-9776 |
| Full Name | A Fresh Start Behavioral Health Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2407 Grace Ave, New Bern, North Carolina |
| Authorized Official Name and Position | Anthony Lamont Harris (OWNER/MANAGER) |
| Authorized Official Contact | 2524149776 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Fresh Start Behavioral Health Services, Pllc Po Box 1992 Greenville NC 27835-1992 Ph: () - | A Fresh Start Behavioral Health Services, Pllc 2407 Grace Ave New Bern NC 28562-4416 Ph: (252) 414-9776 |
| NPI Number | 1710499223 |
|---|---|
| Provider Enumeration Date | 10/25/2017 |
| Last Update Date | 01/29/2021 |
| Certification Date | 01/29/2021 |
| Medicare PECOS PAC ID | 9931466646 |
|---|---|
| Medicare Enrollment ID | O20180117002275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710499223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C008809 (North Carolina) | Primary |
| Provider Name | Anthony L Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902283633 PECOS PAC ID: 5991096497 Enrollment ID: I20160613002275 |
| Provider Name | Rhonda Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598211724 PECOS PAC ID: 3779862321 Enrollment ID: I20161122001926 |
| Provider Name | Peggy Lynette Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861886970 PECOS PAC ID: 0446507339 Enrollment ID: I20200629003263 |
| Provider Name | Christy Janel Joyner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386924702 PECOS PAC ID: 4082020144 Enrollment ID: I20210316000144 |
| Provider Name | Alexandria Nicole Bonicelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346810462 PECOS PAC ID: 1153724174 Enrollment ID: I20210728000326 |
| Provider Name | Casey Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972928174 PECOS PAC ID: 6608245048 Enrollment ID: I20221207001979 |
| Provider Name | Dwayne Thomas Lawrence |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801908678 PECOS PAC ID: 2668817313 Enrollment ID: I20240304002463 |
| Provider Name | Laura Ann Boswell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881158087 PECOS PAC ID: 4688016835 Enrollment ID: I20240520003740 |
| Provider Name | Bernetta Moore- Sutton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558920017 PECOS PAC ID: 4385186931 Enrollment ID: I20240611000869 |
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