| Intentional Growth Behavioral Health Services, Pllc | |
|
12925 Highway 601 Ste 500 Midland NC 28107-9537 | |
| (252) 287-8620 | |
| Not Available |
| Full Name | Intentional Growth Behavioral Health Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 12925 Highway 601 Ste 500, Midland, North Carolina |
| Authorized Official Name and Position | Ashley Marie Adam (ORGANIZER/ OWNER) |
| Authorized Official Contact | 2522878620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intentional Growth Behavioral Health Services, Pllc 776 Alexander Commons Dr Monroe NC 28112-7650 Ph: (252) 287-8620 | Intentional Growth Behavioral Health Services, Pllc 12925 Highway 601 Ste 500 Midland NC 28107-9537 Ph: (252) 287-8620 |
| NPI Number | 1639778905 |
|---|---|
| Provider Enumeration Date | 10/19/2020 |
| Last Update Date | 12/31/2022 |
| Certification Date | 12/31/2022 |
| Medicare PECOS PAC ID | 2163835224 |
|---|---|
| Medicare Enrollment ID | O20210108001761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639778905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ashley M Adam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073963906 PECOS PAC ID: 8628316064 Enrollment ID: I20190211002437 |
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