Healthcare Provider Details

I. General information

NPI: 1649417635
Provider Name (Legal Business Name): MOUNTAIN COUNSELING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 N COUNTRY CLUB RD
BREVARD NC
28712-8908
US

IV. Provider business mailing address

PO BOX 2722
HENDERSONVILLE NC
28793-2722
US

V. Phone/Fax

Practice location:
  • Phone: 828-883-9676
  • Fax: 828-884-9753
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNC

VIII. Authorized Official

Name: ERICA R COOK
Title or Position: OFFICE MANAGER
Credential:
Phone: 828-692-7300