Provider Demographics
NPI:1396989133
Name:EAST CAROLINA UNIVERSITY
Entity type:Organization
Organization Name:EAST CAROLINA UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:ATHERTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCAS, LPC, CCS
Authorized Official - Phone:252-744-6290
Mailing Address - Street 1:COLLEGE OF ALLIED HEALTH SCIENCES-ECU
Mailing Address - Street 2:DARS - NAVIGATE COUNSELING CLINIC
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4353
Mailing Address - Country:US
Mailing Address - Phone:252-744-6290
Mailing Address - Fax:252-744-6311
Practice Address - Street 1:COLLEGE OF ALLIED HEALTH SCIENCES-ECU
Practice Address - Street 2:DARS - NAVIGATE COUNSELING CLINIC
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4353
Practice Address - Country:US
Practice Address - Phone:252-744-6290
Practice Address - Fax:252-744-6311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-074-206251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health