| NPI | 1629474614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN SIMMONS President 704-996-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 251B00000X Case Management | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |