Provider Demographics
NPI:1467115311
Name:BEST SELF COLLABORATIVE CARE
Entity Type:Organization
Organization Name:BEST SELF COLLABORATIVE CARE
Other - Org Name:BEST SELF-COLLABORATIVE CARE SERVICES, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAESHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:CPB
Authorized Official - Phone:302-883-7787
Mailing Address - Street 1:439 WESTWOOD SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1532
Mailing Address - Country:US
Mailing Address - Phone:855-523-7822
Mailing Address - Fax:910-779-2416
Practice Address - Street 1:4030 WAKE FOREST RD STE 349
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-0010
Practice Address - Country:US
Practice Address - Phone:855-523-7822
Practice Address - Fax:910-779-2416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1467115311OtherNPI 2
NC1548892052OtherNPI 1