| Family Ties Mental Health And Substance Abuse Counseling Services | |
|
720 N 3rd St Ste 401 Wilmington NC 28401-3474 | |
| (910) 769-9126 | |
| (910) 769-9169 |
| Full Name | Family Ties Mental Health And Substance Abuse Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 720 N 3rd St Ste 401, Wilmington, North Carolina |
| Authorized Official Name and Position | Bridget Dixon Milliken (OWNER) |
| Authorized Official Contact | 9103938502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Ties Mental Health And Substance Abuse Counseling Services 720 N 3rd St Ste 401 Wilmington NC 28401-3474 Ph: (910) 769-9126 | Family Ties Mental Health And Substance Abuse Counseling Services 720 N 3rd St Ste 401 Wilmington NC 28401-3474 Ph: (910) 769-9126 |
| NPI Number | 1831682665 |
|---|---|
| Provider Enumeration Date | 06/06/2018 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 7911309430 |
|---|---|
| Medicare Enrollment ID | O20210707000615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831682665 | NPI | - | NPPES |
| 1265776876 | Medicaid | NC | |
| L774 | Medicaid | NC |
| Provider Name | Joanna Wolicki-shannon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245240969 PECOS PAC ID: 4385612290 Enrollment ID: I20040920000202 |
| Provider Name | Chae W Kwak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174773246 PECOS PAC ID: 1658603154 Enrollment ID: I20191104000533 |
| Provider Name | Alan Robert Brailsford De Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235600057 PECOS PAC ID: 1052744539 Enrollment ID: I20200520002237 |
| Provider Name | Margaret Higgins Kaplan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356914394 PECOS PAC ID: 6305231689 Enrollment ID: I20220323002193 |
| Provider Name | Bridget Dixon Milliken |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265776876 PECOS PAC ID: 4284036708 Enrollment ID: I20240108005459 |
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