Healthcare Provider Details

I. General information

NPI: 1619108115
Provider Name (Legal Business Name): PROGRESSIVE HEALTHCARE & COUNSELING SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2009
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 VANCE ST
CLINTON NC
28328-4001
US

IV. Provider business mailing address

7013 MISSIONARY RIDGE DR
RALEIGH NC
27610-6349
US

V. Phone/Fax

Practice location:
  • Phone: 919-694-6402
  • Fax: 800-875-5876
Mailing address:
  • Phone: 910-475-6124
  • Fax: 919-779-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number8109498
License Number StateNC

VIII. Authorized Official

Name: LLEWELLYN HICKS
Title or Position: PRESIDENT
Credential:
Phone: 919-520-1783