| Innovative Behavioral Health Services P.c. | |
|
402 Main St Creedmoor NC 27522 | |
| (919) 529-2474 | |
| Not Available |
| Full Name | Innovative Behavioral Health Services P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 402 Main St, Creedmoor, North Carolina |
| Authorized Official Name and Position | Benjamin Joseph Mastridge (PRESIDENT) |
| Authorized Official Contact | 9195292474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Behavioral Health Services P.c. Po Box 400 Creedmoor NC 27522-0400 Ph: (919) 529-2474 | Innovative Behavioral Health Services P.c. 402 Main St Creedmoor NC 27522 Ph: (919) 529-2474 |
| NPI Number | 1124367347 |
|---|---|
| Provider Enumeration Date | 02/07/2013 |
| Last Update Date | 02/23/2022 |
| Certification Date | 02/23/2022 |
| Medicare PECOS PAC ID | 5799929675 |
|---|---|
| Medicare Enrollment ID | O20130913000814 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124367347 | NPI | - | NPPES |
| Provider Name | Pamela Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588655666 PECOS PAC ID: 2163436072 Enrollment ID: I20060131000316 |
| Provider Name | Benjamin Mastridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942421508 PECOS PAC ID: 2860649068 Enrollment ID: I20120823000070 |
| Provider Name | Clarence David Runnels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487129649 PECOS PAC ID: 3870838576 Enrollment ID: I20181228000741 |
| Provider Name | Vincent J Cella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235775545 PECOS PAC ID: 4183052335 Enrollment ID: I20200321000334 |
| Provider Name | Bani'ci' N Townsend-harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649944844 PECOS PAC ID: 8123412749 Enrollment ID: I20220224002504 |
| Provider Name | Marlon J Bynum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013577881 PECOS PAC ID: 6608254552 Enrollment ID: I20240110001784 |
| Provider Name | Jonathan D Youmans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528430469 PECOS PAC ID: 5698119311 Enrollment ID: I20240221000403 |
| Provider Name | Amy P Myrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194405449 PECOS PAC ID: 5890135073 Enrollment ID: I20240506000539 |
Creedmoor Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2527 E Lyon Station Rd, Creedmoor, NC 27522 Phone: 919-528-2558 Fax: 919-528-2971 | |
Creedmoor Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2527 E Lyon Station Rd, Creedmoor, NC 27522 Phone: 919-528-2558 Fax: 919-528-2971 | |
The Hope Well America, Llc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 402 N. Main Street, Creedmoor, NC 27522 Phone: 919-590-0426 | |
Creedmoor Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2527 E Lyon Station Rd, Creedmoor, NC 27522 Phone: 919-528-2558 Fax: 919-528-2971 | |
Creedmoor Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2527 E Lyon Station Rd, Creedmoor, NC 27522 Phone: 919-528-2558 Fax: 919-528-2971 | |
Alliance Center 2 Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1556 Nc Hwy 56, B-104, Creedmoor, NC 27422 Phone: 252-252-1381 Fax: 252-598-0051 |