NPIMap

Organization Active NPI

Marvin D. Coulthard

Doing business as Tar River Psychological Associates

  • Mental Health Counselor
  • Tarboro, NC
National Provider Identifier
1336283837
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4630 Issued in NC
Legal business name
MARVIN D. COULTHARD
Doing business as
Tar River Psychological Associates
Practice address
325 N Main St
Tarboro, NC 27886-5009
Phone
(252) 823-2927
Fax
(252) 823-8792
NPI assigned
Feb 16, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Marvin David Coulthard, LPANPI 1548314180
Title
Administrator
Phone
(252) 823-2927

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1118 NC
Mental Health Counselor 101YM0800X 4630 NC Primary
Professional Counselor 101YP2500X 4058 NC
Psychologist 103T00000X 0734 NC
Social Worker 104100000X C000554 NC

Addresses

Primary practice location

325 N Main St
Tarboro, NC 27886-5009

Mailing address

325 N Main St
Tarboro, NC 27886-5009

Other identifiers 2

IdentifierTypeStateIssuer
6005951MedicaidNC
131UROtherNCBLUECROSSBLUESHIELD

Other names 1

  • Tar River Psychological Associates Doing business as

National Provider Directory

National Provider Directory

Locations

325 N Main St
Tarboro, NC 27886
Phone (252) 823-2927

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1336283837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278865009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278865009",
            "telephone_number": "252-823-2927",
            "fax_number": "252-823-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN D. COULTHARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "COULTHARD",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "252-823-2927",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1118",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4630",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4058",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "0734",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C000554",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005951",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "131UR",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tar River Psychological Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tarboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.