| Thomas M Waite Lcsw | |
|
102 Castle Ct Elizabeth City NC 27909-7737 | |
| (252) 335-9239 | |
| (252) 335-9239 |
| Full Name | Thomas M Waite Lcsw |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 102 Castle Ct, Elizabeth City, North Carolina |
| Authorized Official Name and Position | Thomas Michael Waite (CEO) |
| Authorized Official Contact | 2523359239 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas M Waite Lcsw 102 Castle Ct Elizabeth City NC 27909-7737 Ph: (252) 335-9239 | Thomas M Waite Lcsw 102 Castle Ct Elizabeth City NC 27909-7737 Ph: (252) 335-9239 |
| NPI Number | 1679960868 |
|---|---|
| Provider Enumeration Date | 04/25/2015 |
| Last Update Date | 04/25/2015 |
| Medicare PECOS PAC ID | 8224349790 |
|---|---|
| Medicare Enrollment ID | O20150624002580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679960868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C003627 (North Carolina) | Primary |
| Provider Name | Thomas M Waite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194879536 PECOS PAC ID: 0446394407 Enrollment ID: I20100215000772 |
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