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3101 Ward Blvd Suite B Wilson NC 27893-1729 | |
| (252) 243-7030 | |
| (252) 243-7034 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3101 Ward Blvd, Wilson, North Carolina |
| Authorized Official Name and Position | Lisa G Sullivan (DIRECTOR OF SUPPORT SERVICES) |
| Authorized Official Contact | 9197849182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
134 Wind Chime Ct Raleigh NC 27615-6433 Ph: (919) 784-9182 | 3101 Ward Blvd Suite B Wilson NC 27893-1729 Ph: (252) 243-7030 |
| NPI Number | 1184765422 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184765422 | NPI | - | NPPES |
| 018KJ | Other | NC | NC BCBS |
| 6005775 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Regrowth Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5217 Castlewood Dr, Wilson, NC 27893 Phone: 336-210-5627 | |
Teaching Academics For Life Learning Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4345 Georgetown Dr N, Wilson, NC 27896 Phone: 252-230-2689 | |
Heal And Restore, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2270 Nash St N, Wilson, NC 27896 Phone: 252-696-4091 Fax: 929-290-0328 | |