MEDICARE: CAPE FEAR CASE MANAGEMENT & COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	106H00000X	Marriage & Family Therapist
3	101YM0800X	Mental Health Counselor

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

General Provider Information

NPI Number	:	1982902227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPE FEAR CASE MANAGEMENT & COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	4536 TECHNOLOGY DR
Second Line	:	SUITE 2
City	:	WILMINGTON
State	:	NC
Zip	:	28405-2172
Country	:	US
Telephone Number	:	910-399-6184
Fax Number	:	910-399-6186

Provider Business Practice Location Address
First Line	:	4536 TECHNOLOGY DR
Second Line	:	SUITE 2
City	:	WILMINGTON
State	:	NC
Zip	:	28405-2172
Country	:	US
Telephone Number	:	910-399-6184
Fax Number	:	910-399-6186

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MRS. JENNIFER KATHRYN PARRELLA
Credential	:	MS, LPC
Telephone Number	:	910-399-6184

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	03/10/2011

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