Provider Demographics
NPI:1205131067
Name:PERSON CENTERED PARTNERSHIPS INC
Entity type:Organization
Organization Name:PERSON CENTERED PARTNERSHIPS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:CAMILLE
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MBH/MHA
Authorized Official - Phone:704-319-7601
Mailing Address - Street 1:PO BOX 32301
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28232-2301
Mailing Address - Country:US
Mailing Address - Phone:704-567-0790
Mailing Address - Fax:704-567-8735
Practice Address - Street 1:5108 REAGAN DR STE 9
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-1394
Practice Address - Country:US
Practice Address - Phone:704-567-0790
Practice Address - Fax:704-567-8735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X, 103TC0700X, 103TP0016X, 1041C0700X, 251B00000X
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300388Medicaid
NC8302704Medicaid
NC3803418Medicaid
NC3410143Medicaid