Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASHEBA KEY-ALLRED (CONTRACT SPECIALIST)
(919) 783-8898
Entity
Organization
Contact information
Practice address
414 W LEBANON ST, MOUNT AIRY, NC 27030-2954
(336) 789-9492
(336) 789-9587
Mailing address
5171 GLENWOOD AVE, SUITE 211, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018KJ
NC BCBS
NC
05
—
6005805
—
NC
Enumeration date
12/15/2006
Last updated
04/24/2017
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