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General NPI Number Information
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NPI Number | 1568372530
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Entity Type | Organization
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Legal Business Name | TREE OF LIFE CLT INC
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 1113 FORDHAM RD
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City | CHARLOTTE
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State | NC
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Zip | 28208-6215
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Country | US
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Telephone | 302-268-7813
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Fax |
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Provider Business Mailing Address
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Address Line | 7547 TANGLEWOOD WAY
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City | DENVER
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State | NC
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Zip | 28037-9207
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Country | US
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Telephone | 302-268-7813
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DAYRIN DREW
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Credential |
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Telephone | 302-268-7813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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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