| NPI | 1346552056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY ANTHONY COUSAR Owner 919-210-3774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 251B00000X Case Management | |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2023-08-07 |