| NPI | 1922534080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MEAD Reimbursement/Contract Manager 704-865-3529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |