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Organization
UCA BEHAVIORAL SUPPORT SERVICES, LLC
Active
Organization
UCA BEHAVIORAL SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIETRIX URQUHART (OWNER)
(919) 408-9082
Entity
Organization
Contact information
Practice address
2530 MERIDIAN PKWY STE 300, DURHAM, NC 27713-5273
(919) 408-9082
Mailing address
74 WHITESELL WAY, DURHAM, NC 27703-0747
(919) 408-9082
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103107
—
NC
Enumeration date
06/10/2021
Last updated
11/30/2021
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