Provider Demographics
NPI:1417992702
Name:HEALTHPLUS THERAPEUTIC SERVICES INC
Entity Type:Organization
Organization Name:HEALTHPLUS THERAPEUTIC SERVICES INC
Other - Org Name:HEALTHPLUS THERAPEUTIC SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR CORPORATE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-948-0333
Mailing Address - Street 1:1712 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3315
Mailing Address - Country:US
Mailing Address - Phone:252-948-0333
Mailing Address - Fax:252-948-0933
Practice Address - Street 1:1710 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3315
Practice Address - Country:US
Practice Address - Phone:252-948-0333
Practice Address - Fax:252-948-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103TC0700X, 103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0172EOtherBCBS
NC6005883Medicaid
NC6005856Medicaid
NC6005856Medicaid