Provider Demographics
NPI:1245399203
Name:DIVINE INTERVENTIONS COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:DIVINE INTERVENTIONS COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:ELEANORE
Authorized Official - Last Name:YANKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:252-245-2048
Mailing Address - Street 1:P.O. BOX 3001
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27895-3001
Mailing Address - Country:US
Mailing Address - Phone:252-234-2048
Mailing Address - Fax:252-234-2047
Practice Address - Street 1:3704 TRACE DR W
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8347
Practice Address - Country:US
Practice Address - Phone:252-245-2048
Practice Address - Fax:888-634-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0042701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1379HOtherBCBS PROVIDER NUMBER
NC2113388OtherCIGNA PROVIDER NUMBER
NC1379HOtherBCBS PROVIDER NUMBER