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

433 W Main St
Durham, NC 27701-3217

Phone

(919) 433-0170

Fax

(919) 433-0156

NPI assigned

Dec 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard P Edwards

Title

Vice President

Phone

(919) 783-8898

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Catherine Blythe Clemmer, MSW, LCSW

  • Clinical Social Worker
  • Durham, NC
  • NPI 1215105747
  NPD (past)
• Cristina Q. Flake, LCSW

  • Mental Health Counselor
  • Durham, NC
  • NPI 1750448395
  NPD (past)
• Deanna Pickett, LPC

  • Professional Counselor
  • Durham, NC
  • NPI 1902104961
  NPD (past)
• Peter Sterrett, LCSW

  • Clinical Social Worker
  • Durham, NC
  • NPI 1033111398
  NPD (past)
• Susan Rachele Jessup, LCSW, LCAS

  • Clinical Social Worker
  • NPI 1437356896
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1265594105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 400",
            "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": "433 W MAIN ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013217",
            "telephone_number": "919-433-0170",
            "fax_number": "919-433-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "919-783-8898",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005819",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BCBS GROUP",
            "identifier": "018 KJ",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark E Easley, M.D.
• Hannah Elizabeth Eason
• Pamela D. Eason, SLP
• Easter Seals Ucp Norht Carolina & Virginia, Inc
• Easter Seals Ucp North Carolina & Virginia
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc. (Easterseals PORT Health)
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Chandler Moeller Easterhoff, CPNP

• Mental Health Counselor in Durham, NC
• Providers in Durham, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.