Colony Behavioral Health Group, Pllc

LBN: Colony Behavioral Health Group, Pllc
Colony Behavioral Health Group, Pllc is an health care organization with primary practice located at 2804 Village Way , Trent Woods NC 28562-7305. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Counseling is the primary health care specialty. Colony Behavioral Health Group, Pllc can be contacted via phone (252) 636-0112, or through Jacobson, Bethanne Thumm via phone (252) 636-0112.

Contact Information

Primary practice address
2804 Village Way Trent Woods NC 28562-7305
Phone: (252) 636-0112
Fax: (252) 634-9778
Website:
Map and Directions
Authorized official contact:
Name: Jacobson, Bethanne Thumm PH.D.
Phone: (252) 636-0112

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X LPC1030 North Carolina
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X PCAS28 North Carolina
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2021 North Carolina
Behavioral Health & Social Service Providers / Counseling 103TC1900X 3037 North Carolina

Profile Details

NPI number 1770536054
LBN Legal business name Colony Behavioral Health Group, Pllc
DBA Doing business as
Authorized official Jacobson, Bethanne Thumm PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2006
Last updated Jun 25th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770536054 NPPES
North Carolina MEDICAID 6006464
North Carolina Other 0197Q

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