MEDICARE: EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	251B00000X	Case Management Agency
3	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306167713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

Provider Business Mailing Address
First Line	:	5171 GLENWOOD AVE
Second Line	:	SUITE 211
City	:	RALEIGH
State	:	NC
Zip	:	27612-3266
Country	:	US
Telephone Number	:	919-783-8898
Fax Number	:	919-782-5486

Provider Business Practice Location Address
First Line	:	5000 FALLS OF NEUSE RD STE 300
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-5480
Country	:	US
Telephone Number	:	919-865-8710
Fax Number	:	919-256-0772

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	BRETT BEAVERS
Credential	:
Telephone Number	:	919-210-7661

Provider Enumeration Date	:	06/21/2010
Last Update Date	:	10/17/2024

Similar Medicare Providers

1487513743 — ALEXANDER CHAO
Practice Location Address:

5000 FALLS OF NEUSE RD STE 300
RALEIGH, NC
27609-5480

Practice Phone: 919-865-8710
Practice Fax:

1164096913 — KATHRYN CHRISTINA LANE LCMHC
Practice Location Address:

5000 FALLS OF NEUSE RD STE 300
RALEIGH, NC
27609-5480

Practice Phone: 919-865-8710
Practice Fax: 919-256-0772

1780881714 — BERNARD DOUGLAS COX JR. LCMHC
Practice Location Address:

5000 FALLS OF NEUSE RD STE 300
RALEIGH, NC
27609-5480

Practice Phone: 919-865-8710
Practice Fax: 919-256-0772

1639496862 — MRS. ASHLEY DANIELLE MARROW MSW, LCSW
Practice Location Address:

5000 FALLS OF NEUSE RD
RALEIGH, NC
27609-5480

Practice Phone: 919-651-8904
Practice Fax: 919-657-8776

1902238322 — ASHLEY ELIZABETH CAMPBELL MSW,LCSW,LCAS
Practice Location Address:

5000 FALLS OF NEUSE RD
RALEIGH, NC
27609-5480

Practice Phone: 919-651-8826
Practice Fax:

1043613391 — SAMANTHA JO REDFERN PHARMD
Practice Location Address:

5000 FALLS OF NEUSE RD , SUITE 300
RALEIGH, NC
27609-5480

Practice Phone: 984-200-1549
Practice Fax: 984-200-2542

Directions to “EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.