Healthcare Provider Details

I. General information

NPI: 1871883132
Provider Name (Legal Business Name): HDHOLISTIC EDUCATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MCCULLOUGH DR
CHARLOTTE NC
28262-3310
US

IV. Provider business mailing address

PO BOX 621211
CHARLOTTE NC
28262-0120
US

V. Phone/Fax

Practice location:
  • Phone: 704-620-2987
  • Fax: 704-943-4264
Mailing address:
  • Phone: 704-620-2987
  • Fax: 704-909-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA CLINTON-PRICE
Title or Position: OWNER/PRESIDENT
Credential: M.ED.
Phone: 704-620-2987