Provider Demographics
NPI:1356809990
Name:ATLANTIC CONSULTING AND THERAPY SPECIALISTS, PA
Entity type:Organization
Organization Name:ATLANTIC CONSULTING AND THERAPY SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:252-565-8836
Mailing Address - Street 1:3493 EVANS ST STE E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4535
Mailing Address - Country:US
Mailing Address - Phone:252-565-8836
Mailing Address - Fax:
Practice Address - Street 1:3493-E EVANS STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4535
Practice Address - Country:US
Practice Address - Phone:252-565-8836
Practice Address - Fax:252-565-8837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-02
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty