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Organization

COUNTY OF JOHNSTON NORTH CAROLINA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANYA KAY SMITH (INFORMATION PROCESSING TECHNICIAN)
(919) 989-5539
Entity
Organization

Contact information

Practice address
521 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4407
(919) 989-5500
Mailing address
521 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4407
(919) 989-5500
(833) 438-7008

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC0700X
Clinical Psychologist
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QP0905X
State or Local Public Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029NP
BCBS
NC
05
3404351
NC
05
3404436
NC
Enumeration date
06/26/2012
Last updated
09/24/2025
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