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General NPI Number Information
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NPI Number | 1275694978
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Entity Type | Organization
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Legal Business Name | CLAY WILSON & ASSOCIATES
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 929 15TH ST NE STE 100
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City | HICKORY
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State | NC
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Zip | 28601
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Country | US
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Telephone | 828-327-6026
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Fax | 828-327-8796
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Provider Business Mailing Address
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Address Line | 4330 VIOLA SIPE DR
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City | CONOVER
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State | NC
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Zip | 28613-8839
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Country | US
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Telephone | 828-256-3436
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Fax | 828-256-3623
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Authorized Official
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Title or Position | PRESIDENT - CEO
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Name | MRS. JULIE WALKER
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Credential |
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Telephone | 828-256-3436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MHL018056
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License Number State | NC
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Taxonomy #2
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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 #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHL018056
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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