| NPI | 1497000319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON CHRISTOPHER HALL Owner/Operator 910-795-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C005936) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC C005936) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC C005936) | |
| 101YM0800X Counselor, Mental Health (Licence: NC C005936) | |
| 102L00000X Psychoanalyst (Licence: NC C005936) | |
| 103K00000X Behavior Analyst (Licence: NC C005936) | |
| 104100000X Social Worker (Licence: NC C005936) | |
| 1041S0200X Social Worker, School (Licence: NC C005936) | |
| 106H00000X Marriage & Family Therapist (Licence: NC C005936) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |