| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 81 Main St, Clyde, North Carolina |
| Authorized Official Name and Position | John Koppelmeyer (PRESIDENT/CEO) |
| Authorized Official Contact | 7048724157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 99 Webster NC 28788-0099 Ph: (828) 586-8958 | 81 Main St Clyde NC 28721-8519 Ph: (828) 627-2800 |
| NPI Number | 1588956403 |
|---|---|
| Provider Enumeration Date | 05/11/2011 |
| Last Update Date | 05/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588956403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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