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General NPI Number Information
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NPI Number | 1457939076
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Entity Type | Organization
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Legal Business Name | NICOLE SUTTON BEHAVIORAL THERAPY
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 750C NW BROAD ST
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4102
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Country | US
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Telephone | 910-585-6091
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Fax | 910-246-1681
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Provider Business Mailing Address
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Address Line | 360 WHIPPOORWILL LN
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City | PINEBLUFF
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State | NC
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Zip | 28373-5502
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Country | US
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Telephone | 910-783-5636
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. NATALIE N SUTTON
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Credential | LCSW, LCAS
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Telephone | 910-783-5636
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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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