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General NPI Number Information
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NPI Number | 1124310396
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Entity Type | Organization
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Legal Business Name | OPEN HEARTS OPEN MINDS
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Dates
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Enumeration Date | 05/06/2011
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Last Update Date | 05/06/2011
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Provider Practice Location Address
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Address Line | 7609 DELUCA DR
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City | CHARLOTTE
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State | NC
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Zip | 28215-5313
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Country | US
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Telephone | 704-536-0737
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Fax |
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Provider Business Mailing Address
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Address Line | 7609 DELUCA DR
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City | CHARLOTTE
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State | NC
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Zip | 28215-5313
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Country | US
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Telephone | 704-536-0737
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. LASHICA HEMINGWAY
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Credential | LPC, NBC
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Telephone | 704-536-0737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | NC
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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 | 5488
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5488
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5488
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License Number State | NC
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