Provider Demographics
NPI:1003109133
Name:SECUREHANDS BEHAVIORAL HEALTH SERVICES, PLLC
Entity type:Organization
Organization Name:SECUREHANDS BEHAVIORAL HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, BC-TMH NCC
Authorized Official - Phone:910-308-2286
Mailing Address - Street 1:PO BOX 25234
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5003
Mailing Address - Country:US
Mailing Address - Phone:910-308-2286
Mailing Address - Fax:
Practice Address - Street 1:2827 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5403
Practice Address - Country:US
Practice Address - Phone:910-987-9430
Practice Address - Fax:910-868-6181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8341251B00000X, 101YP2500X, 101Y00000X, 101YM0800X, 251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104670Medicaid
NC6008487Medicaid