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Organization
TYSON'S CORNER HEALTH SERVICES, INC.
Active
Organization
TYSON'S CORNER HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CASPERTINE HAWKINS (CEO)
(252) 407-8469
Entity
Organization
Contact information
Practice address
600 N GRACE ST, UNIT D, ROCKY MOUNT, NC 27804-4843
(252) 407-8469
Mailing address
2100 N HERITAGE ST, UNIT B, KINSTON, NC 28501-2222
(252) 407-8469
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921354
—
NC
05
—
6008809
—
NC
Enumeration date
08/30/2011
Last updated
05/12/2014
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