Individual
ARCHIE PENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
3709 NASH ST NW, WILSON, NC 27896-1127
(252) 206-5799
(252) 206-5778
Mailing address
4354 PINE TREE CT, WILSON, NC 27893-8590
(252) 363-1675
(252) 206-5778
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-21378
NC
1041C0700X
Clinical Social Worker
P010209
NC
Other
Enumeration date
10/16/2013
Last updated
06/25/2019
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