Provider Demographics
NPI:1194945709
Name:REPAY, INC.
Entity type:Organization
Organization Name:REPAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-438-6218
Mailing Address - Street 1:PO BOX 2423
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-2423
Mailing Address - Country:US
Mailing Address - Phone:828-438-6218
Mailing Address - Fax:828-439-2340
Practice Address - Street 1:420 W FLEMING DR
Practice Address - Street 2:SUITE C
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3966
Practice Address - Country:US
Practice Address - Phone:828-438-6218
Practice Address - Fax:828-439-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2549103T00000X
NC0370103T00000X, 103TC0700X
NCC0069091041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006021Medicaid
NC017X7OtherBCBSNC
NC017X7OtherBCBSNC