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815 Davie Ave Statesville NC 28677-5310 | |
| (704) 871-1712 | |
| (704) 871-9354 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 815 Davie Ave, Statesville, North Carolina |
| Authorized Official Name and Position | Bryan G Hatcher (PRESIDENT) |
| Authorized Official Contact | 3367160858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
146 E Mclelland Ave Mooresville NC 28115-2611 Ph: (704) 871-1712 | 815 Davie Ave Statesville NC 28677-5310 Ph: (704) 871-1712 |
| NPI Number | 1831302918 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 06/15/2022 |
| Certification Date | 06/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831302918 | NPI | - | NPPES |
| 2351672A | Other | NC | MEDICARE |
| 2336116 | Other | NC | MEDICARE |
| 6005460 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
Behavioral Healthcare & Memory Institute Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215b W Broad St, Statesville, NC 28677 Phone: 704-878-8884 Fax: 704-878-8883 | |
Hopewell Behavioral Health Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 S Center St Ste 116, Statesville, NC 28677 Phone: 704-325-9654 Fax: 704-973-9488 | |
Iredell County Dss Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 549 Eastside Dr, Statesville, NC 28625 Phone: 704-873-5631 Fax: 704-871-3489 | |
Cnc Access Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Stockton St, Statesville, NC 28677 Phone: 800-866-0860 |