Organization
SNAPBACK NC, CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COURTNEY LAYNE BUTLER NCCPSS (PRESIDENT)
(252) 260-9406
Entity
Organization
Contact information
Practice address
703 N BROAD ST, EDENTON, NC 27932-1430
(252) 698-1389
Mailing address
703 N BROAD ST, EDENTON, NC 27932-1430
(252) 698-1389
(252) 368-1529
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/12/2022
Last updated
03/01/2024
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