Provider Demographics
NPI:1770662157
Name:AURORA BEHAVIORAL INTERVENTIONS, LLC
Entity type:Organization
Organization Name:AURORA BEHAVIORAL INTERVENTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:GRIGG
Authorized Official - Last Name:OXENDALE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC, LCAS
Authorized Official - Phone:828-766-7637
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-0212
Mailing Address - Country:US
Mailing Address - Phone:828-766-7637
Mailing Address - Fax:828-766-7637
Practice Address - Street 1:517-B ALTAPASS HWY
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-3012
Practice Address - Country:US
Practice Address - Phone:828-766-7637
Practice Address - Fax:828-766-7637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5333101YP2500X, 101YM0800X
NC1443101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103502Medicaid