NPI Code Details Logo

NPI 1366637753

NPI 1366637753 : QUALITY MENTAL HEALTH : LENOIR, NC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1366637753
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    QUALITY MENTAL HEALTH 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/10/2007
-----------------------------------------------------
    Last Update Date     |    09/10/2007
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    210 MULBERRY ST SW SUITE D
-----------------------------------------------------
    City                 |    LENOIR
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    28645-5450
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    828-754-1366
-----------------------------------------------------
    Fax                  |    866-424-7390
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    210 MULBERRY ST SW SUITE D
-----------------------------------------------------
    City                 |    LENOIR
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    28645-5450
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    828-754-1366
-----------------------------------------------------
    Fax                  |    866-424-7390
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PROGRAM DIRECTOR
-----------------------------------------------------
    Name                 |    MR. CHRISTOPHER  GOULD 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    828-754-1366
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    251B00000X
-----------------------------------------------------
    Taxonomy Name        |    Case Management Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    251S00000X
-----------------------------------------------------
    Taxonomy Name        |    Community/Behavioral Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.