Organization
ROANOKE VALLEY SPECIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERNICE L. LEE M.ED., BS., QP (DIRECTOR,MANAGER)
(252) 533-0045
Entity
Organization
Contact information
Practice address
113 W 10TH STREET, ROANOKE RAPIDS, NC 27870-1364
(252) 533-0045
(252) 533-0046
Mailing address
PO BOX 1364, 113 W 10TH STREET, ROANOKE RAPIDS, NC 27870-1364
(252) 533-0045
(252) 533-0046
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301881
—
NC
Enumeration date
03/20/2007
Last updated
10/13/2011
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