| Self Concepts Clinical Counseling Services, Inc. | |
|
1305 E. Garrison Blvd. Gastonia NC 28054-5127 | |
| (704) 852-3874 | |
| (704) 852-7060 |
| Full Name | Self Concepts Clinical Counseling Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1305 E. Garrison Blvd., Gastonia, North Carolina |
| Authorized Official Name and Position | Melissa A Williams (CEO/PRESIDENT) |
| Authorized Official Contact | 7048523874 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Concepts Clinical Counseling Services, Inc. Po Box 2543 Gastonia NC 28053-2543 Ph: (704) 852-3874 | Self Concepts Clinical Counseling Services, Inc. 1305 E. Garrison Blvd. Gastonia NC 28054-5127 Ph: (704) 852-3874 |
| NPI Number | 1902967862 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 10/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902967862 | NPI | - | NPPES |
| 6005253 | Medicaid | NC | |
| 8300519 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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