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CONCORDIA SUPPORT SERVICES, LLC
NPI 1417045188
Community/Behavioral Health in Fayetteville, NC

Active since October 10, 2006
2315 BLOOM AVENUE, SUITE 2, FAYETTEVILLE, NC 28304(910) 826-8253(910) 826-8254 Get Directions Write a Review

NPPES record last updated: June 25, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Concordia Support Services, Llc NPPES

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

CONCORDIA SUPPORT SERVICES, LLC (NPI 1417045188) is a healthcare organization registered as a community/behavioral health in Fayetteville, North Carolina and active in the NPI registry since October 2006. The organization lists Meredith Nickelberry, Vice President, as its authorized official.

NPPES Registry Identity

NPI1417045188
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameCONCORDIA SUPPORT SERVICES, LLC
Location Address2315 BLOOM AVENUE, SUITE 2Fayetteville, NC 28304-6165
Mailing AddressPo Box 26108Fayetteville, NC 28314-5018 · (910) 826-8253 · Fax (910) 826-8254
Phone(910) 826-8253
Fax(910) 826-8254
Organization SubpartNo
Authorized OfficialMeredith NickelberryVice President · (910) 826-8253
Enumeration DateOctober 10, 2006
Last NPPES UpdateJune 25, 2009
✔ NPI 1417045188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
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.
Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X
Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X · License MHL-067-156 (NC), MHL-067154 (NC), MHL-047-070 (NC)
Also ListedCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320900000X
2315 BLOOM AVENUE, Fayetteville, NC 28304
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Other Identifiers 18

Medicaid8300605BNC
Medicaid5950244NC
Medicaid6603837NC
Medicaid6603687NC
Medicaid83001129BNC
Medicaid8301129HNC
Medicaid8300604BNC
Medicaid8300605NC
Medicaid8300606NC
Medicaid8300606BNC
Medicaid8301129GNC
Medicaid8300606GNC
Medicaid6603570NC
Medicaid8300604NC
Medicaid8301864NC
Medicaid6006251NC
Medicaid8301864BNC
Medicaid8301129NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Concordia Support Services, LLC's NPI number?

The NPI number for Concordia Support Services, LLC is 1417045188. It was assigned to this organization in the NPPES registry on October 10, 2006.

Where is Concordia Support Services, LLC located?

Concordia Support Services, LLC is located at 2315 Bloom Avenue Suite 2, Fayetteville, NC 28304. The listed phone number is (910) 826-8253.

What is Concordia Support Services, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Concordia Support Services, LLC was last updated on June 25, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.