Healthcare Provider Details

I. General information

NPI: 1013358480
Provider Name (Legal Business Name): ROJ MENTAL HEALTH & SUBSTANCE ABUSE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 HWY 421 N
LILLINGTON NC
27546-0655
US

IV. Provider business mailing address

14 CONULSTANT PLACE SUTE 210
DURHAM NC
27707-6320
US

V. Phone/Fax

Practice location:
  • Phone: 910-814-4243
  • Fax: 910-814-4245
Mailing address:
  • Phone: 919-401-4333
  • Fax: 919-401-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN EDWARD SLOAN
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 919-407-1999