# ST. MARGARET BEHAVIOR HEALTH SERVICES LLC

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

## Provider details

- **NPI number:** 1790928752
- **Authorized official:** MR. COLLINS YEBOA SIAKWAN CLINICAL THERAPIST (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (252) 268-5433

## Contact information

- **Practice address:** 3180 BALLARDS CROSSROADS RD, GREENVILLE, NC 27834-4707
- **Practice address phone:** (252) 227-4009
- **Practice address fax:** (252) 227-4009
- **Mailing address:** 3180 BALLARDS CROSSROADS RD, GREENVILLE, NC 27834-4707
- **Mailing address phone:** (252) 227-4009
- **Mailing address fax:** (252) 227-4009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | 1065 | NC | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1065 | NC | Yes |
| 101YM0800X | Mental Health Counselor | 1065 | NC | — |
| 101YP2500X | Professional Counselor | 1065 | NC | — |

## Other

- **Enumeration date:** 04/07/2009
- **Last updated:** 04/07/2009