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General NPI Number Information
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NPI Number | 1962325621
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Entity Type | Individual
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Provider Name | ROBY CALVIN THOMPSON IV
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Gender | Male
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 720 N 3RD ST STE 101
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City | WILMINGTON
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State | NC
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Zip | 28401-3474
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Country | US
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Telephone | 910-251-2106
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Fax |
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Provider Business Mailing Address
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Address Line | 9 CORBETT ST
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City | WRIGHTSVILLE BEACH
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State | NC
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Zip | 28480-3125
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Country | US
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Telephone | 202-486-2315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LCAS-31928
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P023850
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License Number State | NC
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