FOCUSED ADDICTION RECOVERY LLC — NPI 1114789666 (Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) in WALLACE, NC)

CMS-1500 Box 24J / 33a • NPI

1114789666

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

101YA0400X

Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)

Box 32 Service Location & ZIP+4

102 W MAIN ST, WALLACE, NC, 28466-2902

✓ 9-Digit EDI 837 ZIP+4 (28466-2902)

Practice Phone & Referral Fax

(910) 788-4242

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1114789666 (FOCUSED ADDICTION RECOVERY LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1114789666` (NPI-2 Organization / Facility)
Provider / Legal Name	FOCUSED ADDICTION RECOVERY LLC
Plain-English Specialty	Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) NUCC Code: `101YA0400X` (Counselor, Addiction (Substance Use Disorder))
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	102 W MAIN ST, WALLACE, NC, 28466-2902
Practice Telephone / Fax	Tel: (910) 788-4242
Administrative Mailing Address	102 W MAIN ST, WALLACE, NC, 28466-2902
Enumeration & Last Sync	Enumerated: 2024-01-29 \| CMS Record Updated: 2024-08-30
Authorized Official	CHARLES JACKSON (CCO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

102 W MAIN ST, WALLACE, NC, 28466-2902

🗺️ Open in Google Maps 🏥 More Providers in WALLACE

🔒 Are you FOCUSED ADDICTION RECOVERY LLC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (101YA0400X)

What Does Taxonomy Code 101YA0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YA0400X translates to:
"Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor, Addiction (Substance Use Disorder) for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (FOCUSED ADDICTION RECOVERY LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101Y00000X` — Counselor Plain English: Licensed & Credentialed Counselor	State: N/A \| License: `Verified` \| Primary: Secondary
`101YA0400X` — Counselor, Addiction (Substance Use Disorder) Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Secondary
`101YP2500X` — Counselor, Professional Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Secondary
`103TA0400X` — Psychologist, Addiction (Substance Use Disorder) Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Addiction (Substance Abuse Disorder)	State: N/A \| License: `Verified` \| Primary: Secondary
`103TC1900X` — Psychologist, Counseling Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling	State: N/A \| License: `Verified` \| Primary: Secondary
`163WA0400X` — Registered Nurse, Addiction (Substance Use Disorder) Plain English: Licensed & Credentialed Registered Nurse, Addiction (Substance Use Disorder)	State: N/A \| License: `Verified` \| Primary: Secondary
`207QA0401X` — Family Medicine, Addiction Medicine Plain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)	State: N/A \| License: `Verified` \| Primary: Secondary
`207RA0401X` — Internal Medicine, Addiction Medicine Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: N/A \| License: `Verified` \| Primary: Secondary
`2083A0300X` — Preventive Medicine, Addiction Medicine Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine — Addiction Medicine	State: N/A \| License: `Verified` \| Primary: Secondary
`363LP0808X` — Nurse Practitioner, Psych/Mental Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health	State: N/A \| License: `Verified` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

FOCUSED ADDICTION RECOVERY LLC (NPI #1114789666)