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General NPI Number Information
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NPI Number | 1396214193
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Entity Type | Organization
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Legal Business Name | EUNOIA BEHAVIOR HEALTH SERVICES
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Dates
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Enumeration Date | 11/21/2018
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 1290 HALSTEAD BLVD
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-5840
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Country | US
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Telephone | 252-312-0516
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1614
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City | ELIZABETH CITY
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State | NC
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Zip | 27906-1614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | WILKIAM WILSON
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Credential | LCAS-A
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Telephone | 252-312-0516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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