| Easter Seals Ucp North Carolina & Virginia, Inc. | |
|
5000 Falls Of Neuse Rd Ste 300 Raleigh NC 27609-5480 | |
| (919) 865-8710 | |
| (919) 256-0772 |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5000 Falls Of Neuse Rd Ste 300, Raleigh, North Carolina |
| Authorized Official Name and Position | Brett Beavers (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9192107661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Ucp North Carolina & Virginia, Inc. 5171 Glenwood Ave Suite 211 Raleigh NC 27612-3266 Ph: (919) 783-8898 | Easter Seals Ucp North Carolina & Virginia, Inc. 5000 Falls Of Neuse Rd Ste 300 Raleigh NC 27609-5480 Ph: (919) 865-8710 |
| NPI Number | 1306167713 |
|---|---|
| Provider Enumeration Date | 06/21/2010 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Medicare PECOS PAC ID | 7618161407 |
|---|---|
| Medicare Enrollment ID | O20101105000534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306167713 | NPI | - | NPPES |
| 8300709 | Medicaid | NC | |
| 8301523 | Medicaid | NC | |
| 8300672 | Medicaid | NC | |
| 8300673 | Medicaid | NC | |
| 8300488 | Medicaid | NC | |
| 8300746 | Medicaid | NC | |
| 8301327 | Medicaid | NC | |
| 8301522 | Medicaid | NC | |
| 8300675 | Medicaid | NC | |
| 8300676 | Medicaid | NC |
| Provider Name | Rickie Wade Ellis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831129220 PECOS PAC ID: 8325021553 Enrollment ID: I20040609001097 |
| Provider Name | Paula West Savage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407884042 PECOS PAC ID: 4486680352 Enrollment ID: I20050712000742 |
| Provider Name | Penny L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245216449 PECOS PAC ID: 7416983028 Enrollment ID: I20050714000969 |
| Provider Name | Megan E Bogart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568496883 PECOS PAC ID: 5698761385 Enrollment ID: I20060410000158 |
| Provider Name | Alexia Sandra Maneschi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417000381 PECOS PAC ID: 6406865609 Enrollment ID: I20060417000632 |
| Provider Name | Mandy Wilson Gravitte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730415894 PECOS PAC ID: 0840339396 Enrollment ID: I20091123000569 |
| Provider Name | Hany Aziz Kaoud |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710169990 PECOS PAC ID: 1951435635 Enrollment ID: I20100817000752 |
| Provider Name | Frantz E Pierre |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710168042 PECOS PAC ID: 4587844188 Enrollment ID: I20110215000405 |
| Provider Name | Rena Church |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750669842 PECOS PAC ID: 7012174428 Enrollment ID: I20120213000395 |
| Provider Name | Elaina A Bogan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942394077 PECOS PAC ID: 6709832496 Enrollment ID: I20120710000501 |
| Provider Name | Vinay Paran Saranga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144428673 PECOS PAC ID: 9739361718 Enrollment ID: I20120816000826 |
| Provider Name | Elizabeth L Huston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861554701 PECOS PAC ID: 8426205782 Enrollment ID: I20120822000227 |
| Provider Name | Audrey Deloris Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326482191 PECOS PAC ID: 7719127331 Enrollment ID: I20130702000647 |
| Provider Name | Amy Smith Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245473016 PECOS PAC ID: 0749330108 Enrollment ID: I20131108001130 |
| Provider Name | Christopher Noel Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194150060 PECOS PAC ID: 2860629375 Enrollment ID: I20131207000359 |
| Provider Name | Elizabeth Connelly Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487992483 PECOS PAC ID: 5496057135 Enrollment ID: I20160112001786 |
| Provider Name | Ajay Bankim Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568830529 PECOS PAC ID: 0547540619 Enrollment ID: I20161206002557 |
| Provider Name | Jozef Zelenak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225393663 PECOS PAC ID: 3375817125 Enrollment ID: I20170919000100 |
| Provider Name | Charlene Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346527314 PECOS PAC ID: 1850666785 Enrollment ID: I20171003006487 |
| Provider Name | Alison R Voyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447659321 PECOS PAC ID: 1850656570 Enrollment ID: I20180530002716 |
| Provider Name | Daniel L Ball |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306391867 PECOS PAC ID: 8921345042 Enrollment ID: I20190129000079 |
| Provider Name | Robineta Jovonne Montelina Blackston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568835403 PECOS PAC ID: 4587905591 Enrollment ID: I20190401000484 |
| Provider Name | Maria Teresa Baluis Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679032387 PECOS PAC ID: 0042549842 Enrollment ID: I20190904000341 |
| Provider Name | Christin Perry Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538728217 PECOS PAC ID: 8123357738 Enrollment ID: I20190906002526 |
| Provider Name | Nicole Ann Stoneback |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720646227 PECOS PAC ID: 9133451966 Enrollment ID: I20191029001215 |
| Provider Name | Amy Drozda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760515688 PECOS PAC ID: 2466530621 Enrollment ID: I20210304001679 |
| Provider Name | Sara Sanderson Dodgens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962782920 PECOS PAC ID: 4082007653 Enrollment ID: I20220202001843 |
| Provider Name | Courtney Nichole Barrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992041529 PECOS PAC ID: 3971988213 Enrollment ID: I20220922000996 |
| Provider Name | Tyisha Tamar Teel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992281349 PECOS PAC ID: 5496121337 Enrollment ID: I20221018003489 |
| Provider Name | Allyson Nicole Owens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497302004 PECOS PAC ID: 4587030234 Enrollment ID: I20221020001292 |
| Provider Name | Rochelle Elizabeth Walton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518573906 PECOS PAC ID: 7012389968 Enrollment ID: I20230202001901 |
| Provider Name | Nina Jean Hoaglund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962131003 PECOS PAC ID: 4688020555 Enrollment ID: I20231030000163 |
| Provider Name | Jayce Noelle Inscoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376157230 PECOS PAC ID: 9638529225 Enrollment ID: I20231221004073 |
| Provider Name | Kathryn Christina Lane |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164096913 PECOS PAC ID: 0143671578 Enrollment ID: I20240110000113 |
| Provider Name | Condalette Stone Artero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821589813 PECOS PAC ID: 1355792771 Enrollment ID: I20240110003642 |
| Provider Name | Charles Thomas Dixon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992173363 PECOS PAC ID: 4486005741 Enrollment ID: I20240110005163 |
| Provider Name | Zackary Terry Hawks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164776118 PECOS PAC ID: 1456702729 Enrollment ID: I20240111000342 |
| Provider Name | Isaac Ja-varas Everette |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649640046 PECOS PAC ID: 7113378217 Enrollment ID: I20240112000885 |
| Provider Name | Tonya Carol Oakley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1417007733 PECOS PAC ID: 0345692232 Enrollment ID: I20240116003423 |
| Provider Name | Misty L. Cooke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780069815 PECOS PAC ID: 1759733561 Enrollment ID: I20240117002882 |
| Provider Name | Rolando Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215478292 PECOS PAC ID: 1557713146 Enrollment ID: I20240118004699 |
| Provider Name | William Ashley Mizelle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154497220 PECOS PAC ID: 4981056579 Enrollment ID: I20240119000035 |
| Provider Name | Terin Renee Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770988552 PECOS PAC ID: 4082066691 Enrollment ID: I20240119000786 |
| Provider Name | Allison Yost |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225654387 PECOS PAC ID: 0143672774 Enrollment ID: I20240119001255 |
| Provider Name | Russell Langdon Meyers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235676743 PECOS PAC ID: 6800248352 Enrollment ID: I20240119002211 |
| Provider Name | Jade Ashley Knutson Day |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427332964 PECOS PAC ID: 5597117077 Enrollment ID: I20240119003570 |
| Provider Name | Lauryn Swinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750717708 PECOS PAC ID: 3274978218 Enrollment ID: I20240229000519 |
| Provider Name | Amanda Christine Styron |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942667266 PECOS PAC ID: 0547605149 Enrollment ID: I20240305000768 |
| Provider Name | Tereaka Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669064754 PECOS PAC ID: 9133566581 Enrollment ID: I20240321002080 |
| Provider Name | Fallon Monique Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407456163 PECOS PAC ID: 2860839669 Enrollment ID: I20240327003832 |
| Provider Name | Maegan Starcher Roberson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710266382 PECOS PAC ID: 1759728553 Enrollment ID: I20240327003915 |
| Provider Name | Joshua Hymrick Prince |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386367571 PECOS PAC ID: 7315385135 Enrollment ID: I20240329000534 |
| Provider Name | Jolina Gayle Bild |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538772918 PECOS PAC ID: 6406294966 Enrollment ID: I20240402004383 |
| Provider Name | Linda Cheryl Jacobs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841493533 PECOS PAC ID: 3678911138 Enrollment ID: I20240402004413 |
| Provider Name | Megan Ashley Wingate |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1194002709 PECOS PAC ID: 3577901032 Enrollment ID: I20240402004435 |
| Provider Name | Gwendolyn Long Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720318082 PECOS PAC ID: 1355781212 Enrollment ID: I20240425004085 |
| Provider Name | Janine Renee Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831239599 PECOS PAC ID: 1254674070 Enrollment ID: I20240515001621 |
| Provider Name | Geneva Nicole Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467983726 PECOS PAC ID: 4385186287 Enrollment ID: I20240606003114 |
| Provider Name | Deglan Karl Mccrystal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659100816 PECOS PAC ID: 3870031149 Enrollment ID: I20240817000327 |
| Provider Name | Kelsey Elizabeth Boitnott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689318891 PECOS PAC ID: 3971042482 Enrollment ID: I20240828003910 |
| Provider Name | Briana Francis Talarico |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1619369477 PECOS PAC ID: 9537695242 Enrollment ID: I20241204004154 |
Care One Nursing Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 331 Tryon Rd Suite 103 A, Raleigh, NC 27603 Phone: 919-771-2310 | |
Triumph Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3210 Fairhill Dr, Raleigh, NC 27612 Phone: 919-256-0824 | |
Cheltenham Clinical Services, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2435 Lynn Rd, Suite 200, Raleigh, NC 27612 Phone: 919-438-7396 | |
Pamela J Rosenberg Lcsw Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 867 Washington St, Raleigh, NC 27605 Phone: 919-833-5867 Fax: 919-833-5859 | |
Thriveworks Clinical - North Carolina Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8406 Six Forks Rd Ste 104, Raleigh, NC 27615 Phone: 919-424-6045 Fax: 617-379-0496 | |
Downtown Raleigh Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5109 Carter St, Raleigh, NC 27612 Phone: 910-257-7530 |