Healthcare Provider Details

I. General information

NPI: 1811006778
Provider Name (Legal Business Name): FAMILIY WORKS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 E LONG AVE
GASTONIA NC
28054-2516
US

IV. Provider business mailing address

PO BOX 215
GASTONIA NC
28053-0215
US

V. Phone/Fax

Practice location:
  • Phone: 704-853-8227
  • Fax:
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

VIII. Authorized Official

Name: MS. REBECCA SPENCER JONES
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW,LCSW
Phone: 704-853-8227