# EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

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

## Provider details

- **NPI number:** 1982996674
- **Authorized official:** RICHARD EDWARDS (VP)
- **Authorized official phone:** (919) 783-8898

## Contact information

- **Practice address:** 824 GUM BRANCH RD, SUITES C & D, JACKSONVILLE, NC 28540-6272
- **Practice address phone:** (910) 347-9111
- **Mailing address:** 5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
- **Mailing address phone:** (919) 783-8898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2011
- **Last updated:** 05/12/2011