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General NPI Number Information
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NPI Number | 1164662888
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 02/21/2009
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Last Update Date | 02/21/2009
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Provider Practice Location Address
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Address Line | 503 BOWMAN GRAY DR SUITE C
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City | GREENVILLE
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State | NC
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Zip | 27834-7286
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Country | US
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Telephone | 252-413-0842
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Fax | 252-413-0749
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Provider Business Mailing Address
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Address Line | 503 BOWMAN GRAY DR SUITE C
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City | GREENVILLE
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State | NC
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Zip | 27834-7286
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Country | US
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Telephone | 252-413-0842
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Fax | 252-413-0749
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Authorized Official
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Title or Position | MEMBER
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Name | GWENDOLYN R SHERROD
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Credential | MBA, MHA
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Telephone | 252-413-0842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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 #3
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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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Taxonomy #4
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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