MEDICARE: COUNTY OF WILSON

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	1041C0700X	Clinical Social Worker
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1437950557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF WILSON

Provider Business Mailing Address
First Line	:	PO BOX 459
Second Line	:	100 GOLD ST NE
City	:	WILSON
State	:	NC
Zip	:	27893
Country	:	US
Telephone Number	:	252-206-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 GOLD ST NE
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893
Country	:	US
Telephone Number	:	252-206-4000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KIMBERLY PAIGE IRVINE
Credential	:	MS.
Telephone Number	:	252-206-4000

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	03/11/2026

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Directions to “COUNTY OF WILSON ” Practice Location

Language	Start Address	Practice Location

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