| Support Incorporated | |
|
708 S Chestnut St Gastonia NC 28054-4548 | |
| (704) 865-3525 | |
| (704) 865-3520 |
| Full Name | Support Incorporated |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 708 S Chestnut St, Gastonia, North Carolina |
| Authorized Official Name and Position | Josh Martin (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7048653529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Support Incorporated Po Box 4003 Gastonia NC 28054-0041 Ph: (704) 865-3525 | Support Incorporated 708 S Chestnut St Gastonia NC 28054-4548 Ph: (704) 865-3525 |
| NPI Number | 1780974253 |
|---|---|
| Provider Enumeration Date | 04/18/2011 |
| Last Update Date | 12/30/2015 |
| Medicare PECOS PAC ID | 5991738106 |
|---|---|
| Medicare Enrollment ID | O20050916000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780974253 | NPI | - | NPPES |
| 8303341 | Medicaid | NC | |
| 5918314 | Medicaid | NC | |
| 016V4 | Other | NC | BCBS |
| 6005063 | Medicaid | NC |
| Provider Name | Karen Lynn Melendez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184675977 PECOS PAC ID: 8022170711 Enrollment ID: I20081213000228 |
| Provider Name | Montesha S Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336693159 PECOS PAC ID: 8527347509 Enrollment ID: I20161115000950 |
| Provider Name | Jessica M Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881148039 PECOS PAC ID: 9436553393 Enrollment ID: I20210813003224 |
| Provider Name | Samantha Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699269977 PECOS PAC ID: 8729483904 Enrollment ID: I20210826000824 |
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