Healthcare Provider Details

I. General information

NPI: 1104022847
Provider Name (Legal Business Name): PROGRAM RESOURCE INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 DUBLIN SQUARE RD STE P
ASHEBORO NC
27203-8691
US

IV. Provider business mailing address

108 N ORANGE AVE
DUNN NC
28334-3826
US

V. Phone/Fax

Practice location:
  • Phone: 336-626-9091
  • Fax: 336-625-3720
Mailing address:
  • Phone: 910-891-7062
  • Fax: 910-892-3764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMHL-076-082
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHL-076-082
License Number StateNC

VIII. Authorized Official

Name: MR. TED FITZGERALD
Title or Position: EXECUTIVE DIRECTOR
Credential: M.S.
Phone: 910-891-7062