# COUNTY OF CUMBERLAND

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659401453
- **Authorized official:** MS. DENSIE D LUCAS (ASSISTANT AREA DIRECTOR)
- **Authorized official phone:** (910) 323-0601

## Contact information

- **Practice address:** 711 EXECUTIVE PL, FAYETTEVILLE, NC 28305-5193
- **Practice address phone:** (910) 323-0601
- **Practice address fax:** (910) 323-0096
- **Mailing address:** PO BOX 3069, FAYETTEVILLE, NC 28302-3069
- **Mailing address phone:** (910) 323-0601
- **Mailing address fax:** (910) 323-0096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 01/16/2008