Provider Demographics
NPI:1528405305
Name:CENTER FOR BEHAVIORAL HEALTHCARE, PA
Entity Type:Organization
Organization Name:CENTER FOR BEHAVIORAL HEALTHCARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONATY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LCAS
Authorized Official - Phone:919-776-0303
Mailing Address - Street 1:138 S STEELE ST
Mailing Address - Street 2:SUITE P
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4201
Mailing Address - Country:US
Mailing Address - Phone:919-776-0303
Mailing Address - Fax:919-776-0377
Practice Address - Street 1:1105 E CARDINAL ST
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3300
Practice Address - Country:US
Practice Address - Phone:919-663-3050
Practice Address - Fax:919-663-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC000381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3410094Medicaid
NC2860257COtherMEDICARE PTAN