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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 ANNTIONELLE HAWKINS QP (CEO)
(202) 531-6736
Entity
Organization
Contact information
Practice address
482 WILLIAMSTON DR, WINTERVILLE, NC 28590-9415
(252) 217-4681
(252) 364-2631
Mailing address
8317 SIX FORKS RD, STE. 101, RALEIGH, NC 27615-2104
(252) 217-4681
(252) 364-2631
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NC
101YM0800X
Mental Health Counselor
—
NC
101YP2500X
Professional Counselor
—
NC
103T00000X
Psychologist
—
NC
103TC1900X
Counseling Psychologist
—
NC
103TP2701X
Group Psychotherapy Psychologist
—
NC
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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