Organization
ST. MARGARET BEHAVIOR HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLLINS YEBOA SIAKWAN CLINICAL THERAPIST (CHIEF EXECUTIVE OFFICER)
(252) 268-5433
Entity
Organization
Contact information
Practice address
3180 BALLARDS CROSSROADS RD, GREENVILLE, NC 27834-4707
(252) 227-4009
(252) 227-4009
Mailing address
3180 BALLARDS CROSSROADS RD, GREENVILLE, NC 27834-4707
(252) 227-4009
(252) 227-4009
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1065
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1065
NC
101YM0800X
Mental Health Counselor
1065
NC
101YP2500X
Professional Counselor
1065
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111899
—
NC
Enumeration date
04/07/2009
Last updated
04/07/2009
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