Organization
FAMILY INTERVENTION & PREVENTION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TANYA VICTORIA SMITH MAT (EXECUTIVE DIRECTOR)
(919) 340-1626
Entity
Organization
Contact information
Practice address
200 PARKVIEW DRIVE WEST, SUITE A, HENDERSON, NC 27536-2526
(252) 572-2342
(252) 572-2526
Mailing address
211 COURT ST, LOUISBURG, NC 27549-2526
(919) 340-1626
(919) 340-1627
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
1835P1300X
Psychiatric Pharmacist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
MHL-035-052
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/12/2007
Last updated
05/07/2010
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