| Lake Norman Family Therapy, Pllc | |
|
19900 S Main St Ste 8&9 Cornelius NC 28031-6512 | |
| (704) 892-9490 | |
| (704) 892-9433 |
| Full Name | Lake Norman Family Therapy, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 19900 S Main St Ste 8&9, Cornelius, North Carolina |
| Authorized Official Name and Position | Nichole Danielle Finger (OWNER) |
| Authorized Official Contact | 7048929490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Norman Family Therapy, Pllc Po Box 381 Davidson NC 28036-0381 Ph: (704) 892-9490 | Lake Norman Family Therapy, Pllc 19900 S Main St Ste 8&9 Cornelius NC 28031-6512 Ph: (704) 892-9490 |
| NPI Number | 1255445292 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 03/21/2023 |
| Certification Date | 03/21/2023 |
| Medicare PECOS PAC ID | 3779523014 |
|---|---|
| Medicare Enrollment ID | O20080424000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255445292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Nichole D Finger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740209238 PECOS PAC ID: 0941279954 Enrollment ID: I20040927001110 |
| Provider Name | Lillian Lashae Outlaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760880959 PECOS PAC ID: 5193069615 Enrollment ID: I20220627001105 |
| Provider Name | Angela C Huggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356967277 PECOS PAC ID: 0749669414 Enrollment ID: I20220627001948 |
| Provider Name | Nicole Elizabeth Fallon Sales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225529647 PECOS PAC ID: 1951748375 Enrollment ID: I20240321000768 |
| Provider Name | Heather A Hayes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477062263 PECOS PAC ID: 7012354186 Enrollment ID: I20240325002608 |
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