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General NPI Number Information
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NPI Number | 1902124993
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Entity Type | Organization
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Legal Business Name | DOVE UNITED COUNSELING AND ASSESSMENT SERVICES
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 575 S. SQUARE DRIVE APT 98
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City | WINTERVILLE
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State | NC
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Zip | 28590
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Country | US
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Telephone | 252-258-8045
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 7281
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City | GREENVILLE
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State | NC
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Zip | 27835
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Country | US
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Telephone | 252-258-8045
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | MRS. CATHERINE ADLANDA ROBERTS
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Credential | MS, CRC, LCAS, LPC
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Telephone | 252-258-8045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7249
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1232
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License Number State | NC
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