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General NPI Number Information
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NPI Number | 1336061753
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Entity Type | Organization
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Legal Business Name | FIRST CHANCE MENTAL HEALTH SERVICES OF THE TRIAD PLLC
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 1040 W ILLINOIS AVE
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4518
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Country | US
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Telephone | 910-528-1188
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 W ILLINOIS AVE
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4518
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Country | US
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Telephone | 910-528-1188
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Fax |
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Authorized Official
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Title or Position | OWNER / THERAPIST
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Name | ASIA DEBRA MILLER
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Credential | LCSWA
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Telephone | 910-528-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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