SOUTHEASTERN HEALTHCARE OF NORTH CAROLINA, INC.
NPI 1336290147
Community/Behavioral Health in Raleigh, NC

NPI Status: Active since January 16, 2007

Contact Information

3401 CARL SANDBURG CT
RALEIGH, NC
ZIP 27610
Phone: (919) 212-8580
Fax: (919) 212-8581

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Community/Behavioral Health
CLIA Number: 34D2207795
CLIA Cert. Type: Independent
CLIA Exp. Date: 12-30-2026

About SOUTHEASTERN HEALTHCARE OF NORTH CAROLINA, INC.

This page provides the complete NPI Profile along with additional information for Southeastern Healthcare Of North Carolina, Inc., a provider established in Raleigh, North Carolina operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1336290147 assigned on January 2007. The practitioner's primary taxonomy code is 251S00000X with license number MHL-092-746 (NC). The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Evelyn Sanders Lcsw (Executive Director)

NPI: 1336290147
Provider Name: SOUTHEASTERN HEALTHCARE OF NORTH CAROLINA, INC.
Entity Type: Organization
Location Address: 3401 CARL SANDBURG CT RALEIGH, NC 27610
Location Phone: (919) 212-8580
Location Fax: (919) 212-8581
Mailing Address: PO BOX 14144 RALEIGH, NC 27620
Mailing Phone: (919) 212-8580
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 01-16-2007
Last Update Date: 08-26-2022
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Community/Behavioral Health
Taxonomy Code: 251S00000X
Type: Agencies
License No.: MHL-092-746
License State: NC
Taxonomy Description: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	251E00000X	Agencies	Home Health
2	253Z00000X	Agencies	In Home Supportive Care

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: EVELYN SANDERS LCSW
Authorized Official Title: EXECUTIVE DIRECTOR
Authorized Official Phone: (919) 987-2791

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
8303214	MEDICAID (05)	NC

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 34D2207795
Facility Type: Independent
Certificate Effective Date: December 31, 2024
Certificate Expiration Date: December 30, 2026
Laboratory Director: EVELYN L. SANDERS
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Southeastern Healthcare Of North Carolina, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	3	3	6	2	9	0	1	4	7
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	3	6	6	4	9	0	1	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 6 + 6 + 4 + 9 + 0 + 1 + 8 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 7									7

The NPI number 1336290147 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 7 providers are registered at the same or nearby location.

RACQUEL MERRITT LCSW, LCAS

Social Worker

(Clinical)