Healthcare Provider Details

I. General information

NPI: 1487250965
Provider Name (Legal Business Name): HOLISTIC LIFEWORK SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 N CANNON BLVD STE A
KANNAPOLIS NC
28083-2673
US

IV. Provider business mailing address

2103 N CANNON BLVD STE A
KANNAPOLIS NC
28083-2673
US

V. Phone/Fax

Practice location:
  • Phone: 704-593-6842
  • Fax:
Mailing address:
  • Phone: 704-593-6842
  • Fax:

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TERENCE TABRON
Title or Position: OWNER
Credential:
Phone: 704-960-6180