Easter Seals Ucp North Carolina & Virginia, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

Practice address

414 W Lebanon St
Mount Airy, NC 27030-2954

Phone

(336) 789-9492

Fax

(336) 789-9587

NPI assigned

Dec 15, 2006

Organization subpart

No

Name

Nasheba Key-Allred

Title

Contract Specialist

Phone

(919) 783-8898

Medicare fee-for-service enrollment

Enrolled in NC

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 24, 2017.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1104988047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 211",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898",
            "fax_number": "919-782-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W LEBANON ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302954",
            "telephone_number": "336-789-9492",
            "fax_number": "336-789-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "KEY-ALLRED",
        "authorized_official_first_name": "NASHEBA",
        "authorized_official_title_or_position": "CONTRACT SPECIALIST",
        "authorized_official_telephone_number": "919-783-8898"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BCBS",
            "identifier": "018KJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005805",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffery Bryant Eads, LPC
• William Webster Eads, MDIV
• Lakin East, OTR/L
• Easter Seals Ucp NC & VA, Inc
• Easter Seals Ucp North Carolina & Virgina, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Marcy Easter, PTA
• Molly Kay Easter, NP
• Sherrie Dawn Easter, CADC
• Eckerd Corporation

• All providers in Mount Airy, NC
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.