MEDICARE: PSYCHIATRIC SERVICES OF EASTERN CAROLINA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	207454	NC

General Provider Information

NPI Number	:	1295095438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHIATRIC SERVICES OF EASTERN CAROLINA

Provider Business Mailing Address
First Line	:	302 W DAFFY LN
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-3547
Country	:	US
Telephone Number	:	910-526-3288
Fax Number	:

Provider Business Practice Location Address
First Line	:	302 W DAFFY LN
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-3547
Country	:	US
Telephone Number	:	910-526-3288
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT SEIGEL
Credential	:	NURSE PRACTITIONER
Telephone Number	:	910-526-3288

Provider Enumeration Date	:	05/22/2012
Last Update Date	:	01/13/2026

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