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NPI Code Detail

MEDICARE: SOUTHEASTERN REGIONAL MENTAL HEALTH CENTER

MEDICARE: SOUTHEASTERN REGIONAL MENTAL HEALTH CENTER
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health CounselorNC
3103T00000XPsychologist
41041C0700XClinical Social Worker
5251B00000XCase Management Agency
6251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881608883
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEASTERN REGIONAL MENTAL HEALTH CENTER
Provider Business Mailing Address
First Line : 450 COUNTRY CLUB RD
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-9494
Country : US
Telephone Number : 910-272-1230
Fax Number : 910-272-1299
Provider Business Practice Location Address
First Line : 450 COUNTRY CLUB RD
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-9494
Country : US
Telephone Number : 910-272-1230
Fax Number : 910-272-1299
Authorized Official
Title or Position : FINANCE OFFICER
Name : VICKIE EVANS
Credential : CFO
Telephone Number : 910-272-1230
Provider Enumeration Date : 07/28/2006
Last Update Date : 01/03/2008

Similar Medicare Providers

1245233303 — DR. ROBERT RHEA EARNEST M.D.
Practice Location Address:
460 COUNTRY CLUB RD
LUMBERTON, NC
28360-9494
Practice Phone: 910-608-2100
Practice Fax: 910-608-2102
1609878800 — MS. VICKI E CLARK NP
Practice Location Address:
460 COUNTRY CLUB RD
LUMBERTON, NC
28360-9494
Practice Phone: 910-671-3200
Practice Fax: 910-671-3484
1912909128 — MS. CONNIE ROSE FREEMAN OGNP
Practice Location Address:
460 COUNTRY CLUB RD
LUMBERTON, NC
28360-9494
Practice Phone: 910-671-3200
Practice Fax: 910-671-3484
1053396101 — KRISTIE COLLINS MARTIN PA-C
Practice Location Address:
460 COUNTRY CLUB RD
LUMBERTON, NC
28360-9494
Practice Phone: 910-671-3200
Practice Fax:
1134150485 — MRS. AMANDA L.. CUMMINGS LCSW
Practice Location Address:
460 COUNTRY CLUB RD
LUMBERTON, NC
28360-9494
Practice Phone: 910-671-3453
Practice Fax: 910-671-3484
1932287182 — COUNTY OF ROBESON OFFICE OF TREASURER
Practice Location Address:
460 COUNTRY CLUB RD
LUMBERTON, NC
28360-9494
Practice Phone: 910-671-3200
Practice Fax: 910-671-3484

Directions to “SOUTHEASTERN REGIONAL MENTAL HEALTH CENTER ” 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.

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