Healthcare Provider Details

I. General information

NPI: 1134750367
Provider Name (Legal Business Name): RESILIENT MIND COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 CLAYTON ST
ASHEVILLE NC
28801-2423
US

IV. Provider business mailing address

147 HUDSON ST
ASHEVILLE NC
28806-3307
US

V. Phone/Fax

Practice location:
  • Phone: 828-515-1246
  • Fax: 828-658-5013
Mailing address:
  • Phone: 828-515-1246
  • Fax: 828-658-0513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: PATRICK CASALE
Title or Position: OWNER
Credential: MA, LCMHC, LCAS
Phone: 828-515-1246