Healthcare Provider Details

I. General information

NPI: 1639009178
Provider Name (Legal Business Name): DELITHIUS LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W WALNUT ST
GOLDSBORO NC
27530-3652
US

IV. Provider business mailing address

117 S KORNEGAY ST
GOLDSBORO NC
27530-4963
US

V. Phone/Fax

Practice location:
  • Phone: 919-344-9237
  • Fax: 919-344-9237
Mailing address:
  • Phone: 919-344-9237
  • Fax: 919-344-9237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: COREY DELITHIUS THOMPSON
Title or Position: CEO
Credential: MHA
Phone: 919-344-9237