Organization
ROANOKE VALLEY SPECIAL SERVICES LLC
Active
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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