MEDICARE: ST. MARK'S MANOR 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
1	101YM0800X	Mental Health Counselor	MHL-092-399	NC

General Provider Information

NPI Number	:	1629125109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. MARK'S MANOR INC

Provider Business Mailing Address
First Line	:	PO BOX 1057
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-1057
Country	:	US
Telephone Number	:	919-363-5311
Fax Number	:

Provider Business Practice Location Address
First Line	:	3733 HERITAGE MEADOW LANE
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540
Country	:	US
Telephone Number	:	919-363-5311
Fax Number	:	919-363-5312

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. PRISCILLA C PETTY
Credential	:
Telephone Number	:	919-363-5311

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1528797347 — JAMES ZACHARY FIPPS DPT
Practice Location Address:

781 AVENT FERRY RD STE 110
HOLLY SPRINGS, NC
27540-7776

Practice Phone: 919-645-1411
Practice Fax: 919-781-5246

1588534812 — DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC
Practice Location Address:

401 IRVING PKWY STE 130
HOLLY SPRINGS, NC
27540-5301

Practice Phone: 919-385-5060
Practice Fax: 919-385-5089

1306363148 — DR. AVELINA VILAS PT, DPT
Practice Location Address:

112 GRAND HILL PL
HOLLY SPRINGS, NC
27540-4416

Practice Phone: 919-346-5815
Practice Fax:

1902797707 — KAYLIE TEREASE YSASI M.S.
Practice Location Address:

209 SPRINGLEAF CT
HOLLY SPRINGS, NC
27540-8624

Practice Phone: 252-702-0074
Practice Fax:

1780169623 — MRS. MONICA WILLIAMS FNP
Practice Location Address:

7212 GB ALFORD HWY
HOLLY SPRINGS, NC
27540-7661

Practice Phone: 919-552-1520
Practice Fax:

1750388914 — WALTER T LITTLE III M.ED LPC
Practice Location Address:

804 CREEK HAVEN DR
HOLLY SPRINGS, NC
27540-8372

Practice Phone: 919-362-0577
Practice Fax: 919-680-4883

1649277757 — DR. FEYISAYO ADENIKE ADEYINA M.D.
Practice Location Address:

1004 WERRINGTON DR
HOLLY SPRINGS, NC
27540-6017

Practice Phone: 919-552-9952
Practice Fax: 919-552-3062

Directions to “ST. MARK'S MANOR INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.