Provider Demographics
NPI:1821238494
Name:CARTER BEHAVIOR HEALTH SERVICES
Entity Type:Organization
Organization Name:CARTER BEHAVIOR HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:SPELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-347-3950
Mailing Address - Street 1:115 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1603
Mailing Address - Country:US
Mailing Address - Phone:252-523-5577
Mailing Address - Fax:252-523-8577
Practice Address - Street 1:308 GREENVILLE BLVD SE STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5758
Practice Address - Country:US
Practice Address - Phone:252-353-5577
Practice Address - Fax:252-353-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NC101YM0800X, 251S00000X, 253Z00000X
NCMHL-054-1403245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302510Medicaid