EASTER SEALS UCP NORTH CAROLINA& VIRGINIA, INC (NPI# 1881834653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881834653 |
| Entity Type | Organization |
| Organization Name | EASTER SEALS UCP NORTH CAROLINA& VIRGINIA, INC |
| Practice Address |
1503 Wayne Memorial Dr Unit E Goldsboro NC 27534-2203 |
| Mailing Address |
5171 Glenwood Ave Suite 400 Raleigh NC 27612-3266 |
| Practice Telephone | 9195870001 |
| Practice Fax Number | 9195870007 |
| Mailing Telephone | 9197838898 |
| Mailing Fax Number | 9197825486 |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2015-11-20 |
| Authorized Official Name | MR. RICHARD P EDWARDS (CONTRACT ADMINISTRATOR) |
| Authorized Official Telephone | 9197838898 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300746H | 05 | |
| NC | 8300746B | 05 | |
| NC | 8300746F | 05 | |
| NC | 8300746I | 05 |
| Street Address |
1503 WAYNE MEMORIAL DR UNIT E |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154335511 | Ralph Roger Berg Jr. | Psychiatry & Neurology | 1503 Wayne Memorial Dr, Suite H, Goldsboro, NC 27534-2203 | 2006-07-28 |
| 1396283669 | Destiny Nicole Bauer | Counselor | 1503 Wayne Memorial Dr, Goldsboro, NC 27534-2203 | 2017-02-07 |
| 1780810432 | Clientfirst of Nc, LLC | Community/Behavioral Health | 1503 Wayne Memorial Dr, Suite H, Goldsboro, NC 27534-2203 | 2009-06-09 |
| 1073751327 | Donald E Brown Jr. | Psychiatry & Neurology | 1503 Wayne Memorial Dr, Suite H, Goldsboro, NC 27534-2203 | 2009-01-25 |
| 1760515688 | Amy D Drozda | Social Worker | 1503 Wayne Memorial Dr, Suite E, Goldsboro, NC 27534-2203 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962040782 | Monarch | Community/Behavioral Health | 2717 Isaac Dr, Goldsboro, NC 27530-8120 | 2019-12-11 |
| 1659837383 | Building Healthy Minds, LLC | Community/Behavioral Health | 515 N George St, Goldsboro, NC 27530-2724 | 2019-02-19 |
| 1588027833 | Kaleo Supports, Inc. | Community/Behavioral Health | 300 Autumn Winds Dr, Goldsboro, NC 27530-2506 | 2016-04-04 |
| 1538589593 | Uloanda Parham | Community/Behavioral Health | 608 N Madison Ave, Goldsboro, NC 27530-3100 | 2014-04-17 |
| 1013340173 | Carolina Outreach, LLC | Community/Behavioral Health | 139 N Center St, Goldsboro, NC 27530-3620 | 2013-08-13 |
| 1619242518 | Carolina Residential Services, Inc. | Community/Behavioral Health | 714 Simmons St, Goldsboro, NC 27530-3843 | 2012-03-12 |
| 1326342460 | Laychris Group, Inc | Community/Behavioral Health | 206 W Ash St Ste 2, Goldsboro, NC 27530-3663 | 2011-01-04 |
| 1750684015 | Nova-ic, Inc. | Community/Behavioral Health | 1216 North Dr, Goldsboro, NC 27534-1858 | 2010-12-08 |
| 1831490002 | Family Connections of Goldsboro, LLC | Community/Behavioral Health | 701 E Ash St, Goldsboro, NC 27530-3801 | 2010-11-04 |
| 1629387220 | Bridges of Hope Inc | Community/Behavioral Health | 201 W Ash St Ste 1, Goldsboro, NC 27530-3665 | 2010-09-29 |
| Find all providers in GOLDSBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.