Healthcare Provider Details

I. General information

NPI: 1467759548
Provider Name (Legal Business Name): NYAYP THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 PHILADELPIA CHURCH RD
DALLAS NC
28034
US

IV. Provider business mailing address

1012 PHILADELPIA CHURCH RD
DALLAS NC
28034
US

V. Phone/Fax

Practice location:
  • Phone: 704-922-7722
  • Fax:
Mailing address:
  • Phone: 704-922-7722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. TJUANA LORRAINE MCELHANEY
Title or Position: EXECUTIVE DIRECTOR / OWNER
Credential:
Phone: 704-922-7722