Healthcare Provider Details

I. General information

NPI: 1871260620
Provider Name (Legal Business Name): ASHEVILLE DBT & TRAUMA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 CHURCH ST
ASHEVILLE NC
28801-3623
US

IV. Provider business mailing address

75 CHURCH ST
ASHEVILLE NC
28801-3623
US

V. Phone/Fax

Practice location:
  • Phone: 828-708-9955
  • Fax:
Mailing address:
  • Phone: 828-708-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA ELAINE COX GRANDA
Title or Position: LICENSED PSYCHOLOGIST
Credential: MSED, PHD
Phone: 305-431-4775