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Organization

NIA CHILDREN AND FAMILY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA TOWNSEND LCSW (OWNER/CLINICAL PROGRAM DIRECTOR)
(252) 291-5585
Entity
Organization

Contact information

Practice address
504 GREEN ST E, WILSON, NC 27893-4176
(252) 291-5585
(252) 291-1377
Mailing address
504 GREEN ST E, WILSON, NC 27893-4176
(252) 291-5585
(252) 291-1377

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
C004462
NC
251S00000X
Community/Behavioral Health Agency
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
136X0
BCBS
NC
05
6002748
NC
05
6008112
NC
05
8301730
NC
Enumeration date
11/01/2006
Last updated
11/12/2010
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