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General NPI Number Information
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NPI Number | 1225637796
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Entity Type | Individual
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Provider Name | CINDY VERDOORN LCAS
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Gender | Female
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Dates
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Enumeration Date | 10/25/2020
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Last Update Date | 10/25/2020
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Provider Practice Location Address
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Address Line | 10831 PINEVILLE RD UNIT 9
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City | PINEVILLE
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State | NC
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Zip | 28134-8137
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Country | US
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Telephone | 980-579-4889
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Fax |
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Provider Business Mailing Address
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Address Line | 108 RAINFORD CT
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City | MOORESVILLE
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State | NC
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Zip | 28117-4119
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Country | US
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Telephone | 704-252-1012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 20635
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License Number State | NC
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