| Vision Behavioral Health Services | |
|
104 N Main St Suite 200 Louisburg NC 27549-2516 | |
| (919) 496-7781 | |
| (919) 496-7781 |
| Full Name | Vision Behavioral Health Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 104 N Main St, Louisburg, North Carolina |
| Authorized Official Name and Position | Nicole Decarlo Qualls (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9194967781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vision Behavioral Health Services 104 N Main St Suite 200 Louisburg NC 27549-2516 Ph: (919) 496-7781 | Vision Behavioral Health Services 104 N Main St Suite 200 Louisburg NC 27549-2516 Ph: (919) 496-7781 |
| NPI Number | 1588974158 |
|---|---|
| Provider Enumeration Date | 10/18/2010 |
| Last Update Date | 10/27/2022 |
| Certification Date | 10/27/2022 |
| Medicare PECOS PAC ID | 5395988133 |
|---|---|
| Medicare Enrollment ID | O20130827000600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588974158 | NPI | - | NPPES |
| 8301200 | Medicaid | NC | |
| 6006049 | Medicaid | NC | |
| 5914521 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Neil E Scheurich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821171984 PECOS PAC ID: 5890873137 Enrollment ID: I20080917000615 |
| Provider Name | Connie Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649418971 PECOS PAC ID: 8729138789 Enrollment ID: I20090612000162 |
| Provider Name | Brittany Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659704195 PECOS PAC ID: 1052629532 Enrollment ID: I20151002000524 |
| Provider Name | Kristin Lorene Byers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952663007 PECOS PAC ID: 1254608912 Enrollment ID: I20170531000150 |
| Provider Name | Melissa Dean-appasu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174910152 PECOS PAC ID: 3476855594 Enrollment ID: I20170927003543 |
| Provider Name | Kristie White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467854828 PECOS PAC ID: 9931321437 Enrollment ID: I20171019000538 |
| Provider Name | Jessica C Knox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326557174 PECOS PAC ID: 5092143347 Enrollment ID: I20200319001371 |
| Provider Name | Erica D Brandon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477067569 PECOS PAC ID: 0042690067 Enrollment ID: I20220708001293 |
| Provider Name | Shameka Logan Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972215382 PECOS PAC ID: 9032574918 Enrollment ID: I20230427002636 |
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