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Organization
NOVA IC, INC.
Active
Organization
NOVA IC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY PRIDGEN (CFO)
(919) 734-8803
Entity
Organization
Contact information
Practice address
1031 WH SMITH BLVD, GREENVILLE, NC 27834-5052
(252) 493-6525
(855) 492-1625
Mailing address
PO BOX 11077, GOLDSBORO, NC 27532-1077
(919) 734-8803
(919) 735-6825
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
2518
NC
103T00000X
Psychologist
0715
NC
1041C0700X
Clinical Social Worker
C004079
NC
1041C0700X
Clinical Social Worker
C005336
NC
207Q00000X
Family Medicine Physician
34782
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006439
—
NC
Enumeration date
12/08/2009
Last updated
09/23/2026
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