Healthcare Provider Details

I. General information

NPI: 1023452422
Provider Name (Legal Business Name): LINCOLN COUNTY COALITION AGAINST CHILD ABUSE AND CHILD ADVOCACY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 POLICARP ST
LINCOLNTON NC
28092-7051
US

IV. Provider business mailing address

PO BOX 652
LINCOLNTON NC
28093-0652
US

V. Phone/Fax

Practice location:
  • Phone: 704-736-1155
  • Fax: 704-736-1156
Mailing address:
  • Phone: 704-736-1155
  • Fax: 704-736-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHERRY LYNN REINHARDT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 704-736-1155