| NPI | 1790963999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYIA RICHARDSON Director 704-548-5298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC C004966) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2020-11-02 |