Healthcare Provider Details

I. General information

NPI: 1487789137
Provider Name (Legal Business Name): FAMILY VIOLENCE PROGRAM, INC. OF PITT COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 EVANS ST
GREENVILLE NC
27834-3267
US

IV. Provider business mailing address

PO BOX 8429 823 S. EVANS STREET
GREENVILLE NC
27835-8429
US

V. Phone/Fax

Practice location:
  • Phone: 252-758-4400
  • Fax: 252-752-4197
Mailing address:
  • Phone: 252-758-4400
  • Fax: 252-752-4197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number89714
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number89714
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number89714
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number89714
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number89714
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number89714
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number89714
License Number StateNC
# 8
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number89714
License Number StateNC

VIII. Authorized Official

Name: DIANA C. LUCAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 252-758-4400