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General NPI Number Information
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NPI Number | 1124265533
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Entity Type | Organization
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Legal Business Name | WACCAMAW ASSOCIATES
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 1328 S. MADISON STREET
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City | WHITEVILLE
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State | NC
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Zip | 28472-0918
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Country | US
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Telephone | 910-642-1800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 918
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City | WHITEVILLE
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State | NC
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Zip | 28472-0918
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Country | US
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Telephone | 910-642-1800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUDSON L DUKES,JR
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Credential | PH.D
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Telephone | 910-642-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1810
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1810
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1810
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1810
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License Number State | NC
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Taxonomy #9
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #10
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #11
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #12
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #13
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1810
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License Number State | NC
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Taxonomy #14
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1810
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License Number State | NC
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