Healthcare Provider Details

I. General information

NPI: 1609473230
Provider Name (Legal Business Name): CHADWICK COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2020
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 CIR
BEAUFORT NC
28516-9001
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 TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD HUNTER CHADWICK III
Title or Position: OWNER, MANAGING MEMBER
Credential: MS, LCMHC-S, LCAS
Phone: 252-732-8096