Healthcare Provider Details
I. General information
NPI: 1558755025
Provider Name (Legal Business Name): ERS SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2015
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
327 N QUEEN ST STE 110
KINSTON NC
28501-4985
US
IV. Provider business mailing address
327 N QUEEN ST STE 110
KINSTON NC
28501-4985
US
V. Phone/Fax
- Phone: 855-377-5436
- Fax: 252-523-1685
- Phone: 855-377-5436
- Fax: 252-523-1685
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 780 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WANDA
WILLIAMS
Title or Position: CLINICIAN
Credential: LCAS
Phone: 855-377-5436