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General NPI Number Information
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NPI Number | 1770564031
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Entity Type | Organization
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Legal Business Name | TAR HEEL HUMAN SERVICES-MENTAL HEALTH DIVISION, INC.
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 191 N NC HWY 41
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City | BEULAVILLE
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State | NC
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Zip | 28518
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Country | US
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Telephone | 910-298-6207
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Fax | 910-298-6293
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Provider Business Mailing Address
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Address Line | PO BOX 1321
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City | BEULAVILLE
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State | NC
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Zip | 28518-1321
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Country | US
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Telephone | 910-298-9207
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Fax | 910-298-6293
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MICHAEL B. JONES
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Credential | MA
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Telephone | 910-298-6207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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