Organization
FAMILY PRESERVATION SERVICES OF NC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA KAYE LITTLE (NC QI & TRAINING DIR)
(704) 344-0491
Entity
Organization
Contact information
Practice address
941 W ANDREWS AVE STE I, HENDERSON, NC 27536-2586
(252) 438-4740
Mailing address
PO BOX 759194, BALTIMORE, MD 21275-9194
(828) 225-3100
(828) 225-3604
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TS0200X
School Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950099
—
NC
05
—
6005325
—
NC
Enumeration date
02/02/2007
Last updated
09/11/2014
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