Provider Demographics
NPI:1043547276
Name:PROGRESSIVE HEALTHCARE & COUNSELING SERVICES INC.
Entity type:Organization
Organization Name:PROGRESSIVE HEALTHCARE & COUNSELING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LLEWELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:919-475-6124
Mailing Address - Street 1:7013 MISSIONARY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6349
Mailing Address - Country:US
Mailing Address - Phone:919-475-6124
Mailing Address - Fax:919-735-2211
Practice Address - Street 1:217 N GEORGE ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3626
Practice Address - Country:US
Practice Address - Phone:919-735-2211
Practice Address - Fax:919-735-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health