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NPI Code Detail

MEDICARE: PROGRAM RESOURCE INSTITUTE, INC.

MEDICARE: PROGRAM RESOURCE INSTITUTE, INC.
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
1101Y00000XCounselorMHL-063-070NC
2101YM0800XMental Health CounselorMHL-063-70NC
31041C0700XClinical Social WorkerC004985NC
4101YA0400XAddiction (Substance Use Disorder) CounselorMHL-063-070NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538366638
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROGRAM RESOURCE INSTITUTE, INC.
Provider Business Mailing Address
First Line : 108 N ORANGE AVE
Second Line :
City : DUNN
State : NC
Zip : 28334-3826
Country : US
Telephone Number : 910-891-7062
Fax Number : 910-892-3764
Provider Business Practice Location Address
First Line : 206 N PINE ST
Second Line :
City : ABERDEEN
State : NC
Zip : 28315-2732
Country : US
Telephone Number : 910-944-2189
Fax Number : 910-944-7443
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. TED FITZGERALD
Credential : M.S.
Telephone Number : 910-891-7062
Provider Enumeration Date : 07/02/2007
Last Update Date : 09/11/2025

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Directions to “PROGRAM RESOURCE INSTITUTE, INC. ” Practice Location

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