Provider Demographics
NPI:1023292455
Name:COULTER, JAMES ARTHUR (MSW, LCSW, LCAS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ARTHUR
Last Name:COULTER
Suffix:
Gender:M
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 1:2577 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7813
Mailing Address - Country:US
Mailing Address - Phone:252-830-3426
Mailing Address - Fax:252-752-0938
Practice Address - Street 1:6A DOCTOR'S PARK
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2801
Practice Address - Country:US
Practice Address - Phone:252-744-4500
Practice Address - Fax:252-744-3472
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1175101YA0400X
NCC0057341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)