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General NPI Number Information
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NPI Number | 1457066250
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Entity Type | Organization
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Legal Business Name | RESET MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 620 SUMMIT CROSSING PL STE 305
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City | GASTONIA
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State | NC
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Zip | 28054-2176
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Country | US
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Telephone | 999-999-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 620 SUMMIT CROSSING PL STE 305
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City | GASTONIA
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State | NC
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Zip | 28054-2176
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. RENAE EADES FLOYD
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Credential | DHSC, LCSW
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Telephone | 910-264-9779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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