Provider Demographics
NPI:1679650451
Name:SOUTHERN CROSS COMMUINTY SERVICES INC
Entity Type:Organization
Organization Name:SOUTHERN CROSS COMMUINTY SERVICES INC
Other - Org Name:SOUTHERN CROSS MENTAL HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EAKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-763-3773
Mailing Address - Street 1:3333 ASHLEY CIR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2601
Mailing Address - Country:US
Mailing Address - Phone:910-763-3773
Mailing Address - Fax:910-763-3799
Practice Address - Street 1:2210 WRIGHTSVILLE AVE
Practice Address - Street 2:SUITE 4-D
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2575
Practice Address - Country:US
Practice Address - Phone:910-763-3773
Practice Address - Fax:910-763-3799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6103238101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty