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General NPI Number Information
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NPI Number | 1316901655
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Entity Type | Organization
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Legal Business Name | MOORESVILLE COUNSELING AND RECOVERY SERVICES, PLLC
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 398 N MAIN ST
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City | MOORESVILLE
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State | NC
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Zip | 28115-2454
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Country | US
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Telephone | 704-737-8580
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Fax |
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Provider Business Mailing Address
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Address Line | 149 MISTY ARBOR LN
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City | MOORESVILLE
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State | NC
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Zip | 28117-5100
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Country | US
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Telephone | 704-737-8580
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | DR. JOHN R. CULBRETH
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Credential | PH.D.
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Telephone | 704-737-8580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 2362
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License Number State | NC
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