| Easter Seals Ucp North Carolina & Virginia, Inc. | |
|
100 Loop St Clinton NC 28328-4062 | |
| (910) 596-2221 | |
| (910) 596-2229 |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 100 Loop St, Clinton, North Carolina |
| Authorized Official Name and Position | Nasheba Key-allred (CONTRACT SPECIALIST) |
| 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 211 Raleigh NC 27612-3266 Ph: (919) 783-8898 | Easter Seals Ucp North Carolina & Virginia, Inc. 100 Loop St Clinton NC 28328-4062 Ph: (910) 596-2221 |
| NPI Number | 1235291170 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 04/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235291170 | NPI | - | NPPES |
| 018KJ | Other | NC | NC BCBS |
| 6005778 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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