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

824 Gum Branch Rd
Suites C & D
Jacksonville, NC 28540-6272

Phone

(910) 347-9111

NPI assigned

May 12, 2011

Organization subpart

No

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

Authorized official

Name

Richard Edwards

Title

VP

Phone

(919) 783-8898

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1982996674",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 GUM BRANCH RD",
            "address_2": "SUITES C & D",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406272",
            "telephone_number": "910-347-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP",
        "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": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Jacksonville, NC
• Providers in Jacksonville, 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 May 12, 2011; 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.