Provider Demographics
NPI:1306142666
Name:NC BEHAVIORAL HEALTH AND COUNSELING SERVICES
Entity type:Organization
Organization Name:NC BEHAVIORAL HEALTH AND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-479-2135
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:TIMBERLAKE
Mailing Address - State:NC
Mailing Address - Zip Code:27583-0129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1921 N POINTE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2672
Practice Address - Country:US
Practice Address - Phone:919-479-2135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health