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General NPI Number Information
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NPI Number | 1093682254
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Entity Type | Organization
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Legal Business Name | THE SPACES IN BETWEEN, PLLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 11525 BALLANTYNE GREEN DRIVE APT. 1109
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City | CHARLOTTE
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State | NC
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Zip | 28277
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Country | US
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Telephone | 704-761-8322
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Fax |
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Provider Business Mailing Address
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Address Line | 7014 SMITH CORNERS BLVD # 1080
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City | CHARLOTTE
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State | NC
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Zip | 28269-3793
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Country | US
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Telephone | 704-761-8322
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Fax |
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Authorized Official
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Title or Position | LCSWA
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Name | CHRISTIAN TATE
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Credential | MSW, LCSWA
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Telephone | 704-761-8322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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