WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL
NPI 1114466893
Psychiatric Hospital in Greenville, NC

Q: What is Walter B Jones Center Lakeside Psychiatric Hospital's specialty?

The primary specialty registered for this NPI is Psychiatric Hospital with taxonomy code 283Q00000X.

Active since February 15, 2017CLIA 34D2006593 · Waiver

2577 W 5TH ST, GREENVILLE, NC 27834(252) 707-5091(252) 830-8585 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 7, 2024, Oct 6, 2021, May 7, 2019 and 2 more (5 updates tracked since 2017).

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About Walter B Jones Center Lakeside Psychiatric Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL (NPI 1114466893), doing business as Walter B Jones Alcohol And Drug Abuse Treatment Center, is a healthcare organization registered as a psychiatric hospital in Greenville, North Carolina and active in the NPI registry since February 2017. The organization holds a CLIA Waiver certificate valid through April 25, 2028 and lists Karen Burkes, Deputy Secretary Fbbhdd Services, as its authorized official.

NPPES Registry Identity

NPI1114466893

Entity TypeOrganization

Primary Taxonomy283Q00000X

Legal Business NameWALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL

Location Address2577 W 5TH STGreenville, NC 27834

Mailing Address2577 W 5th StGreenville, NC 27834-7813 · (252) 707-5091 · Fax (252) 830-8585

Phone(252) 707-5091

Fax(252) 830-8585

Organization SubpartNo

Authorized OfficialKaren BurkesDeputy Secretary Fbbhdd Services · (919) 855-4700

Enumeration DateFebruary 15, 2017

Last NPPES UpdateOctober 17, 20245 updates tracked since enumeration

NPPES CertifiedOctober 17, 2024

✔ NPI 1114466893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatric HospitalHospitals

Taxonomy Code283Q00000X

Definition

An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X

2577 W 5TH ST, Greenville, NC 27834

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Other Names 1

Former Legal Business NameWalter B Jones Alcohol And Drug Abuse Treatment Center

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2006593

Walter B Jones Center · Greenville, NC

Active · expires Apr 25, 2028

CLIA Number34D2006593

Laboratory TypeState Alcohol & Drug Ctr

Certificate Effective DateApril 26, 2026

Certificate Expiration DateApril 25, 2028

Laboratory DirectorSonya B. Longest

Laboratory Phone(252) 707-5059

Laboratory LocationWalter B Jones Center2577 West 5th St, Greenville, NC 27834

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL P HOWARD MSW, LCAS, CCS

Counselor (Addiction (Substance Use Disorder))