ST. MARK'S MANOR INC
NPI 1629125109
Counselor - Mental Health in Holly Springs, NC
- Organization
- Counselor
- Mental Health
- CLIA Number: 34D2062994
- CLIA Cert. Type: Other - GROUP HOME
- CLIA Exp. Date: 07-24-2027
About ST. MARK'S MANOR INC
This page provides the complete NPI Profile along with additional information for St. Mark's Manor Inc, a provider established in Holly Springs, North Carolina operating as a Counselor, focusing in mental health . The healthcare provider is registered in the NPI registry with number 1629125109 assigned on January 2007. The practitioner's primary taxonomy code is 101YM0800X with license number MHL-092-399 (NC). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Ms. Priscilla C Petty (Administrator)
- NPI
- 1629125109 Verify this NPI
- Provider Name
- ST. MARK'S MANOR INC
- Entity Type
- Organization
- Location Address
- 3733 HERITAGE MEADOW LANE HOLLY SPRINGS, NC 27540
- Location Phone
- (919) 363-5311
- Location Fax
- (919) 363-5312
- Mailing Address
- PO BOX 1057 HOLLY SPRINGS, NC 27540
- Mailing Phone
- (919) 363-5311
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-05-2007
- Last Update Date
- 08-22-2020
- Code Navigator
A mental health counselor like St. Mark's Manor Inc provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.
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
Counselor Mental Health
- Taxonomy Code
- 101YM0800X
- Type
- Behavioral Health & Social Service Providers
- License No.
- MHL-092-399
- License State
- NC
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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
- 34D2062994
- Facility Type
- Other - GROUP HOME
- Certificate Effective Date
- July 25, 2025
- Certificate Expiration Date
- July 24, 2027
- Laboratory Director
- HERBERT REID
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to St. Mark's Manor 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.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
HOLLY SPRINGS, NC 27540
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629125109, enumerated as an "organization" on January 05, 2007.
The provider is located at 3733 HERITAGE MEADOW LANE HOLLY SPRINGS, NC 27540 and the phone number is (919) 363-5311.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
