Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD P EDWARDS (VICE PRESIDENT)
(919) 783-8898
Entity
Organization
Contact information
Practice address
913 N CAROLINA AVE, STATESVILLE, NC 28677-3414
(704) 871-1045
(704) 883-8638
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018KJ
NC BCBS
NC
05
—
5905484
—
NC
Enumeration date
02/14/2007
Last updated
11/23/2010
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