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Organization

FAMILY PRESERVATION SERVICES OF NC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIRANDA KAYE LITTLE (NC QI & TRAINING DIR)
(704) 344-0491
Entity
Organization

Contact information

Practice address
2609 N DUKE ST, SUITE 504, DURHAM, NC 27704-3048
(919) 401-1151
Mailing address
10304 SPOTSYLVANIA AVE, SUITE 300, FREDERICKSBURG, VA 22408-8602
(540) 710-6085

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
103TH0004X
Health Psychologist
103TS0200X
School Psychologist
104100000X
Social Worker
106H00000X
Marriage & Family Therapist
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6005324
NC
Enumeration date
02/02/2007
Last updated
01/27/2015
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