Healthcare Provider Details

I. General information

NPI: 1417112202
Provider Name (Legal Business Name): BLUEWINDS - PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date: 06/07/2012
Reactivation Date: 03/06/2013

III. Provider practice location address

30 BEARCAT BLVD.
HENDERSONVILLE NC
28791-3622
US

IV. Provider business mailing address

PO BOX 1075
SALUDA NC
28773-1075
US

V. Phone/Fax

Practice location:
  • Phone: 828-696-1536
  • Fax: 828-696-1538
Mailing address:
  • Phone: 828-699-1009
  • Fax: 828-696-1538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. LINDA SPENCER
Title or Position: PRESIDENT
Credential: LPC
Phone: 828-699-1009