| NPI | 1821320334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTELLE M. JOHNSON Clinical Director/Owner 980-613-8312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional (Licence: NC 7710) | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2021-11-22 |