| Easter Seals Ucp North Carolina & Virginia, Inc. | |
|
2315 Myron Dr Raleigh NC 27607-3344 | |
| (919) 861-1600 | |
| (919) 861-1637 |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2315 Myron Dr, Raleigh, North Carolina |
| Authorized Official Name and Position | Richard P Edwards (VICE PRESIDENT) |
| Authorized Official Contact | 9197838898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Ucp North Carolina & Virginia, Inc. 5171 Glenwood Ave Suite 400 Raleigh NC 27612-3266 Ph: (919) 783-8898 | Easter Seals Ucp North Carolina & Virginia, Inc. 2315 Myron Dr Raleigh NC 27607-3344 Ph: (919) 861-1600 |
| NPI Number | 1376605204 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 11/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376605204 | NPI | - | NPPES |
| 5903291 | Medicaid | NC | |
| 018KJ | Other | NC | NC BLUE CROSS BLUE SHEILD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 32314 (North Carolina) | Primary |
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