| NPI | 1447629126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKIA BLACKMON Manager 252-327-2365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |