Healthcare Provider Details

I. General information

NPI: 1699044438
Provider Name (Legal Business Name): ASPIRE TO EXCELLENCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2011
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 HARDING PL
CHARLOTTE NC
28204-2825
US

IV. Provider business mailing address

1100 HARDING PL
CHARLOTTE NC
28204-2825
US

V. Phone/Fax

Practice location:
  • Phone: 704-909-6271
  • Fax:
Mailing address:
  • Phone: 704-909-6271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. YVONNE KELLY
Title or Position: GENERAL MANGER
Credential: MA
Phone: 704-909-6271