| NPI | 1497533087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE BERNICE WILSON Owner/Licensed Clinician 910-964-0075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103K00000X Behavior Analyst | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist Clinical | |
| 103TP0814X Psychologist Psychoanalysis | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 171400000X | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2023-09-15 |