Organization
FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, INC
Active
Parent organization
PROVIDENCE SERVICE CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE SERVICE CORPORATION
Authorized official
MIRANDA KAYE LITTLE (NC QI & TRAINING DIR)
(704) 344-0491
Entity
Organization
Contact information
Practice address
3824 BARRETT DR, SUITE200, RALEIGH, NC 27609-7220
(704) 344-0491
(704) 233-0493
Mailing address
PO BOX 759194, BALTIMORE, MD 21275-9194
(710) 540-6085
(710) 540-6447
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TS0200X
School Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302457
—
NC
Enumeration date
11/03/2008
Last updated
09/11/2014
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