Healthcare Provider Details

I. General information

NPI: 1639720253
Provider Name (Legal Business Name): SURVIVING THE BATTLE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 EXECUTIVE CENTER DR STE 243
CHARLOTTE NC
28212-8854
US

IV. Provider business mailing address

5501 EXECUTIVE CENTER DR STE 243
CHARLOTTE NC
28212-8854
US

V. Phone/Fax

Practice location:
  • Phone: 678-596-0441
  • Fax: 800-754-8620
Mailing address:
  • Phone: 678-596-0441
  • Fax: 800-754-8620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. MELVIN R BATTLE
Title or Position: CLINICAL DIRECTOR/ CEO
Credential: LCMHC
Phone: 678-596-0441