Healthcare Provider Details

I. General information

NPI: 1649865742
Provider Name (Legal Business Name): SOUTHMOUNTAIN CHILDREN AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 03/02/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 S MAIN ST
MARION NC
28752-4527
US

IV. Provider business mailing address

PO BOX 3387
MORGANTON NC
28680-3387
US

V. Phone/Fax

Practice location:
  • Phone: 828-584-1105
  • Fax:
Mailing address:
  • Phone: 828-584-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LISA MCFARLAND
Title or Position: FINANCE OFFICER
Credential:
Phone: 828-584-1105