MEDICARE: EASTER SEALS UCP NORTH 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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1962556696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTER SEALS UCP NORTH CAROLINA

Provider Business Mailing Address
First Line	:	5700 EXECUTIVE CENTER DR
Second Line	:	SUITE 110
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-8858
Country	:	US
Telephone Number	:	704-566-6040
Fax Number	:	704-971-2537

Provider Business Practice Location Address
First Line	:	3405 W WENDOVER AVE STE H
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-1525
Country	:	US
Telephone Number	:	336-272-9602
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	MRS. NASHEBA YVETTE KEY-ALLRED
Credential	:
Telephone Number	:	919-865-8632

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	03/09/2021

Similar Medicare Providers

1427984426 — ANNETTE RENEE HARRIS LCSW-A
Practice Location Address:

3405 W WENDOVER AVE STE A
GREENSBORO, NC
27407-1525

Practice Phone: 336-404-5787
Practice Fax:

1982907838 — JOURNEYS COUNSELING CENTER INC.
Practice Location Address:

3405 W WENDOVER AVE STE A
GREENSBORO, NC
27407-1525

Practice Phone: 336-294-1349
Practice Fax: 336-292-6711

1255718672 — LINDA BRADLEY
Practice Location Address:

3405 W WENDOVER AVE STE F
GREENSBORO, NC
27407-1525

Practice Phone: 336-323-1385
Practice Fax:

1215311568 — CRAIG BENTON
Practice Location Address:

3405 W WENDOVER AVE STE F
GREENSBORO, NC
27407-1525

Practice Phone: 336-323-1385
Practice Fax:

1609391234 — DR. SUSIE O. TROXLER INC
Practice Location Address:

3405 W WENDOVER AVE STE E
GREENSBORO, NC
27407-1525

Practice Phone: 336-324-1610
Practice Fax: 800-699-7219

1124595533 — VANIQUA HINES
Practice Location Address:

3405 W WENDOVER AVE STE A
GREENSBORO, NC
27407-1525

Practice Phone: 336-294-1349
Practice Fax: 336-292-6711

Directions to “EASTER SEALS UCP NORTH CAROLINA ” 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.