Provider Demographics
NPI:1841495033
Name:WILSON COUNTY DEPT OF SOCIAL SERVICES
Entity type:Organization
Organization Name:WILSON COUNTY DEPT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLOUGHBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-206-4010
Mailing Address - Street 1:100 GOLD ST NE
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4020
Mailing Address - Country:US
Mailing Address - Phone:252-206-4010
Mailing Address - Fax:252-206-4198
Practice Address - Street 1:100 GOLD ST NE
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4020
Practice Address - Country:US
Practice Address - Phone:252-206-4010
Practice Address - Fax:252-206-4198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005748Medicaid