Organization
SOUTHEASTERN REGIONAL MENTAL HEALTH
Active
Other names
Walk-In Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI EVANS (CFO)
(910) 272-1217
Entity
Organization
Contact information
Practice address
207 W 29TH ST, LUMBERTON, NC 28358-2901
(910) 618-5606
Mailing address
450 COUNTRY CLUB RD, LUMBERTON, NC 28360-9494
(910) 738-5261
(910) 738-8230
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901282
—
NC
Enumeration date
04/13/2009
Last updated
04/13/2009
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