Provider Demographics
NPI:1174754675
Name:PROGRESSIVE HELATHCARE & COUNSELING SERVICES INC.
Entity type:Organization
Organization Name:PROGRESSIVE HELATHCARE & COUNSELING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LLEWELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:919-694-6402
Mailing Address - Street 1:476 S PARLIAMENT WAY
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5055
Mailing Address - Country:US
Mailing Address - Phone:919-520-1783
Mailing Address - Fax:800-875-5876
Practice Address - Street 1:4086 BARRETT DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6604
Practice Address - Country:US
Practice Address - Phone:919-694-6402
Practice Address - Fax:800-875-5876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 261QM0850X
NCHC3862253Z00000X
NC8109498251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No253Z00000XAgenciesIn Home Supportive Care