Organization
WACCAMAW ASSOCIATES
Active
Other names
Waccamaw Pyschological Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JUDSON L DUKES,JR PH.D (OWNER)
(910) 642-1800
Entity
Organization
Contact information
Practice address
1328 S. MADISON STREET, WHITEVILLE, NC 28472-0918
(910) 642-1800
Mailing address
PO BOX 918, WHITEVILLE, NC 28472-0918
(910) 642-1800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1810
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
1810
NC
101YM0800X
Mental Health Counselor
1810
NC
101YP2500X
Professional Counselor
1810
NC
103T00000X
Psychologist
Primary
1810
NC
103TA0700X
Adult Development & Aging Psychologist
1810
NC
103TB0200X
Cognitive & Behavioral Psychologist
1810
NC
103TC0700X
Clinical Psychologist
1810
NC
103TC1900X
Counseling Psychologist
1810
NC
103TC2200X
Clinical Child & Adolescent Psychologist
1810
NC
103TF0000X
Family Psychologist
1810
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
1810
NC
103TP0814X
Psychoanalysis Psychologist
1810
NC
103TS0200X
School Psychologist
1810
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000179
—
NC
Enumeration date
01/08/2009
Last updated
01/08/2009
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