| Child & Family Therapy Center, Pc | |
|
363 Williamson Rd Suite 102 Mooresville NC 28117-5973 | |
| (704) 664-7148 | |
| (704) 664-3086 |
| Full Name | Child & Family Therapy Center, Pc |
|---|---|
| Speciality | Counselor |
| Location | 363 Williamson Rd, Mooresville, North Carolina |
| Authorized Official Name and Position | Betty Wright Russell (OWNER) |
| Authorized Official Contact | 7046647148 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Child & Family Therapy Center, Pc 363 Williamson Rd Suite 102 Mooresville NC 28117-5973 Ph: (704) 664-7148 | Child & Family Therapy Center, Pc 363 Williamson Rd Suite 102 Mooresville NC 28117-5973 Ph: (704) 664-7148 |
| NPI Number | 1275788119 |
|---|---|
| Provider Enumeration Date | 11/19/2008 |
| Last Update Date | 03/03/2015 |
| Medicare PECOS PAC ID | 2365637196 |
|---|---|
| Medicare Enrollment ID | O20101105001197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275788119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | C000914 (North Carolina) | Primary |
| Provider Name | Betty W Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912983685 PECOS PAC ID: 3072708809 Enrollment ID: I20101105001219 |
| Provider Name | Aimee Culler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215206214 PECOS PAC ID: 4486998051 Enrollment ID: I20190301000752 |
| Provider Name | Rhonda Flowers-corpening |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114425915 PECOS PAC ID: 7618393158 Enrollment ID: I20200814001590 |
| Provider Name | Seth S Labovitz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043273410 PECOS PAC ID: 9638525728 Enrollment ID: I20231025003300 |
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