Healthcare Provider Details

I. General information

NPI: 1093733040
Provider Name (Legal Business Name): FAMILY GUIDANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 US HIGHWAY 70 SE
HICKORY NC
28602
US

IV. Provider business mailing address

17 US HIGHWAY 70 SE
HICKORY NC
28602
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-1400
  • Fax: 828-322-8958
Mailing address:
  • Phone: 828-322-1400
  • Fax: 828-322-8958

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 TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA KEREKES
Title or Position: INDIVIDUAL & FAMILY COUNSELING PROG
Credential: MSW, LCSWA
Phone: 828-322-1400