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Contact Information

CMC-NORTHEAST, INC.
105 YADKIN STREET
SUITE 302
ALBEMARLE, NC28001-3454
 Phone: 704-403-1877
 Fax: 704-986-2150
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Counselor

101Y00000X
 

Family

103TF0000X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
 

Professional

101YP2500X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CMC-NORTHEAST, INC.

NPI Number 1184777617
LBN Legal business name CMC-NORTHEAST, INC.
Authorized official FRIEDA LOWDER - (VP PHYSICIAN SERVICES)
Entity Organization
Organization subpart 1 Yes
Enumeration date 01/19/2007
Last updated 06/01/2012 - About 14 years ago
Identifiers
NC Medicaid 5906956
NC Medicaid 6005328
NC Medicaid 89015E5
NC Other 019G5 BCBS EFF 7-1-07
NC Other 019G5 BCBSNC
NC Other 355573 MAMSI
NC Other 6006579 MEDICAID, EFF 10/27/2008
NC Other B948 PARTNERS MEDICARE CHOICE
NC Other CC2854 RAILROAD MEDICARE
NC Other DF8926 RAILROAD MEDICARE PTAN
NC Other 566000156058 TRICARE STANDARD, NON NWK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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