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Organization
SOUTHEASTERN REGIONAL MENTAL HEALTH CENTER
Active
Organization
SOUTHEASTERN REGIONAL MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE EVANS CFO (FINANCE OFFICER)
(910) 272-1230
Entity
Organization
Contact information
Practice address
450 COUNTRY CLUB RD, LUMBERTON, NC 28360-9494
(910) 272-1230
(910) 272-1299
Mailing address
450 COUNTRY CLUB RD, LUMBERTON, NC 28360-9494
(910) 272-1230
(910) 272-1299
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NC
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3404926
—
NC
05
—
3408189
—
NC
05
—
8300922
—
NC
Enumeration date
07/28/2006
Last updated
01/03/2008
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