| NPI | 1437541877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN AUDREY CLARK Lcsw/Lisw Cp 704-907-8242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2023-12-13 |