| |
131 W Lebanon St Suite C&e Mount Airy NC 27030-2935 | |
(336) 786-1922 | |
(336) 786-1923 |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 131 W Lebanon St, Mount Airy, North Carolina |
Authorized Official Name and Position | Steven N. Scoggin (PRESIDENT) |
Authorized Official Contact | 3367167339 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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131 W Lebanon St Suite C&e Mount Airy NC 27030-2935 Ph: (336) 786-1922 | 131 W Lebanon St Suite C&e Mount Airy NC 27030-2935 Ph: (336) 786-1922 |
NPI Number | 1760685945 |
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Provider Enumeration Date | 06/06/2007 |
Last Update Date | 06/15/2022 |
Certification Date | 06/15/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760685945 | NPI | - | NPPES |
6005243 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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