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General NPI Number Information
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NPI Number | 1194219147
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Entity Type | Organization
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Legal Business Name | AT THE HEART OF THE,INC MATTER CHRISTIAN COUNSLEING CENTER INC
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2020 REMOUNT RD STE 119
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City | GASTONIA
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State | NC
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Zip | 28054-7476
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Country | US
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Telephone | 704-869-8383
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Fax | 704-675-5038
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Provider Business Mailing Address
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Address Line | 2020 REMOUNT RD STE 119
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City | GASTONIA
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State | NC
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Zip | 28054-7476
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Country | US
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Telephone | 704-869-8383
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Fax | 704-675-5038
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ERIC JAMES COWART
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Credential | PHD.,LPCS
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Telephone | 704-869-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 55083
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License Number State | NC
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