Provider Demographics
NPI:1902124993
Name:DOVE UNITED COUNSELING AND ASSESSMENT SERVICES
Entity Type:Organization
Organization Name:DOVE UNITED COUNSELING AND ASSESSMENT SERVICES
Other - Org Name:DUCAS
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:ADLANDA
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CRC, LCAS, LPC
Authorized Official - Phone:252-258-8045
Mailing Address - Street 1:P.O. BOX 7281
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835
Mailing Address - Country:US
Mailing Address - Phone:252-258-8045
Mailing Address - Fax:
Practice Address - Street 1:575 S. SQUARE DRIVE
Practice Address - Street 2:APT 98
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590
Practice Address - Country:US
Practice Address - Phone:252-258-8045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1232101YA0400X
NC7249101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty