| NPI | 1518369966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN SIMMONS President 704-996-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YS0200X Counselor, School | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TH0100X Psychologist, Health Service | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 104100000X Social Worker | |
| 1041S0200X Social Worker, School | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |