Organization
ADVANTAGE PSYCHIATRY & COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL HERRING (CEO)
(910) 371-1007
Entity
Organization
Contact information
Practice address
1003 OLD WATERFORD WAY, STE 1C, LELAND, NC 28451-4102
(910) 371-1007
(910) 371-6003
Mailing address
1003 OLD WATERFORD WAY, STE 1C, LELAND, NC 28451-4102
(910) 371-1007
(910) 371-6003
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139H9
BCBS GROUP
NC
01
—
141MV
BCBS GROUP
NC
05
—
5900767
—
NC
05
—
6005840
—
NC
Enumeration date
06/20/2006
Last updated
08/22/2020
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