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General NPI Number Information
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NPI Number | 1053053611
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Entity Type | Organization
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Legal Business Name | NOVA LUX COUNSELING
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 101 N TRYON ST STE 112
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City | CHARLOTTE
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State | NC
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Zip | 28246-0104
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Country | US
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Telephone | 475-237-4575
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Fax | 866-213-3606
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Provider Business Mailing Address
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Address Line | 101 N TRYON ST STE 112
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City | CHARLOTTE
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State | NC
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Zip | 28246-0104
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Country | US
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Telephone | 475-237-4575
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Fax | 866-213-3606
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Authorized Official
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Title or Position | OWNER
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Name | DR. BOBBY KATO
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Credential | MD, PHD, MS, LPC
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Telephone | 475-289-0884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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