Provider Demographics
NPI:1588833602
Name:AUGUSTUS, DEMARVIS (MSW, LCSW, LCAS)
Entity Type:Individual
Prefix:MS
First Name:DEMARVIS
Middle Name:
Last Name:AUGUSTUS
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2842 NEUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2839
Mailing Address - Country:US
Mailing Address - Phone:252-514-4770
Mailing Address - Fax:252-514-4773
Practice Address - Street 1:2842 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2839
Practice Address - Country:US
Practice Address - Phone:252-514-4770
Practice Address - Fax:252-514-4773
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0065051041C0700X
NC1408101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)