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Organization
PORT HEALTH SERVICES
Active
Organization
PORT HEALTH SERVICES
Active
Other names
PORT Human Services
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT BEAVERS (CREDENTIALING MANAGER)
(919) 210-7661
Entity
Organization
Contact information
Practice address
3715 GUARDIAN AVE, MOREHEAD CITY, NC 28557-4323
(252) 222-3144
(252) 222-3358
Mailing address
4300 SAPPHIRE CT STE 110, GREENVILLE, NC 27834-9079
(252) 830-7561
(252) 413-0932
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/13/2015
Last updated
05/24/2023
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