Healthcare Provider Details

I. General information

NPI: 1730773565
Provider Name (Legal Business Name): AFFECTIVE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1756C E 11TH ST
SILER CITY NC
27344-2820
US

IV. Provider business mailing address

1184 RUFUS BREWER RD
SILER CITY NC
27344-6973
US

V. Phone/Fax

Practice location:
  • Phone: 919-930-1484
  • Fax:
Mailing address:
  • Phone: 919-930-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JAMES EARL HALL
Title or Position: OWNER, THERAPIST
Credential: LCMHC, LCAS, CSI
Phone: 919-930-1484