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Organization
MARVIN D. COULTHARD
Active
Organization
MARVIN D. COULTHARD
Active
Other names
Tar River Psychological Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN DAVID COULTHARD LPA (ADMINISTRATOR)
(252) 823-2927
Entity
Organization
Contact information
Practice address
325 N MAIN ST, TARBORO, NC 27886-5009
(252) 823-2927
(252) 823-8792
Mailing address
325 N MAIN ST, TARBORO, NC 27886-5009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1118
NC
101YM0800X
Mental Health Counselor
Primary
4630
NC
101YP2500X
Professional Counselor
4058
NC
103T00000X
Psychologist
0734
NC
104100000X
Social Worker
C000554
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131UR
BLUECROSSBLUESHIELD
NC
05
—
6005951
—
NC
Enumeration date
02/16/2007
Last updated
09/11/2025
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