Healthcare Provider Details

I. General information

NPI: 1528473923
Provider Name (Legal Business Name): RICHARD HUNTER CHADWICK III MS, LCAS, LCMHC-S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SALTER PATH RD STE F
PINE KNOLL SHORES NC
28512-6136
US

IV. Provider business mailing address

105 CHELSEA CIRCLE
BEAUFORT NC
28516
US

V. Phone/Fax

Practice location:
  • Phone: 336-703-7706
  • Fax:
Mailing address:
  • Phone: 252-732-8096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-20368
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberS-11043
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS-11043
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: