Organization
ASSOCIATE BEHAVIORAL SERVICES, INC.
Active
Other names
Associate Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY MOORE MA (CLINICAL DIRECTOR)
(910) 735-0556
Entity
Organization
Contact information
Practice address
325 E 4TH ST, LUMBERTON, NC 28358-5526
(910) 735-0556
(910) 735-0557
Mailing address
325 E 4TH ST, LUMBERTON, NC 28358-5526
(910) 735-0556
(910) 735-0557
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MHL-078-161
NC
101YM0800X
Mental Health Counselor
Primary
MHL-078-161
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136W3
LCSW
NC
01
—
140JU
LPC PROVIDER
NC
01
—
140JV
LPC PROVIDER
NC
05
—
3409650
—
NC
05
—
6002814
—
NC
05
—
6003212
—
NC
05
—
6005212
—
NC
05
—
6102230
—
NC
05
—
6102788
—
NC
05
—
6601365
—
NC
01
—
8300249B
COMMUNITY SUPPORTS
NC
01
—
8300249G
DX ASSESSMENT
NC
01
—
8300249H
IN HOME
NC
01
—
8300308B
COMMUNITY SUPPORTS
NC
01
—
8300308H
DX ASSESSMENT
NC
01
—
8300348B
COMMUNITY SUPPORTS
NC
01
—
8300348G
DX ASSESSMENT
NC
01
—
8300348H
IN HOME
NC
05
—
8988468
—
NC
Enumeration date
11/17/2006
Last updated
09/11/2007
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