# INTEGRATED BEHAVIORAL HEALTH MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780033233
- **Authorized official:** MARYANN CATHERINE RICHARDSON (DIRECTOR)
- **Authorized official phone:** (704) 910-6142

## Contact information

- **Practice address:** 8430 MEDICAL PLAZA DR STE 300, CHARLOTTE, NC 28262-9758
- **Practice address phone:** (704) 910-6142
- **Practice address fax:** (980) 422-0106
- **Mailing address:** 8430 MEDICAL PLAZA DR STE 300, CHARLOTTE, NC 28262-9758
- **Mailing address phone:** (704) 910-6142
- **Mailing address fax:** (908) 422-0106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 5004974 | NC | — |
| 261QM0850X | Adult Mental Health Clinic/Center | 5004974 | NC | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 5004974 | NC | — |
| 261QP2300X | Primary Care Clinic/Center | 5004974 | NC | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2016
- **Last updated:** 01/26/2024