Healthcare Provider Details

I. General information

NPI: 1306754759
Provider Name (Legal Business Name): MTK THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S SALEM ST STE 424
APEX NC
27502-1863
US

IV. Provider business mailing address

315 S SALEM ST STE 424
APEX NC
27502-1863
US

V. Phone/Fax

Practice location:
  • Phone: 910-593-2316
  • Fax:
Mailing address:
  • Phone: 910-593-2316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA AYERS-KLOSE
Title or Position: OWNER/CLINICIAN
Credential: LCAS,CCS-I, ALC
Phone: 919-817-4742