| Wgen Css | |
|
2313 Sunset Ave Rocky Mount NC 27804-2529 | |
| (919) 851-5114 | |
| Not Available |
| Full Name | Wgen Css |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2313 Sunset Ave, Rocky Mount, North Carolina |
| Authorized Official Name and Position | Tara Fields (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9198515114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wgen Css Po Box 30549 Raleigh NC 27622-0549 Ph: (919) 851-5114 | Wgen Css 2313 Sunset Ave Rocky Mount NC 27804-2529 Ph: (919) 851-5114 |
| NPI Number | 1629139381 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 09/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629139381 | NPI | - | NPPES |
| 8300411B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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