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General NPI Number Information
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NPI Number | 1316830375
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Entity Type | Organization
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Legal Business Name | PIRATE COUNSELING
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 930 W 15TH ST
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City | WASHINGTON
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State | NC
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Zip | 27889-3533
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Country | US
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Telephone | 252-495-5067
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Fax |
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Provider Business Mailing Address
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Address Line | 610 W 15TH ST STE 6
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City | WASHINGTON
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State | NC
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Zip | 27889-3527
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Country | US
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Telephone | 252-495-5067
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Fax |
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Authorized Official
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Title or Position | ORGANIZER/MEMBER
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Name | AMANDA BRIGHT SOMERS
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Credential | LCSW
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Telephone | 252-495-5067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NULL
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