Basic Information
| Provider Information | |||||||||
| NPI: | 1730160557 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIERPONT | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | RUGGLES | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 751069 | ||||||||
| Address2: | ECU PHYSICIANS | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282751069 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 905 JOHNS HOPKINS DR | ||||||||
| Address2: | ECU PHYSICIANS PSYCHIATRIC MEDICINEOUTPATIENT CENTER | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278347225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527441406 | ||||||||
| FaxNumber: | 2527442419 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| LastUpdateDate: | 11/09/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C003284 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 234637 | 01 | NC | MHN | OTHER | 11731 | 01 | NC | BCBS | OTHER | 6003095 | 05 | NC | MEDICAID | D4637 | 01 | MED COST | OTHER |