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General NPI Number Information
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NPI Number | 1609354067
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Entity Type | Organization
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Legal Business Name | THE VIRTUE PLACE
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Dates
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Enumeration Date | 07/29/2018
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Last Update Date | 07/29/2018
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Provider Practice Location Address
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Address Line | 6135 PARK SOUTH DR STE 510
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City | CHARLOTTE
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State | NC
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Zip | 28210-0100
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Country | US
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Telephone | 704-945-7157
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Fax |
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Provider Business Mailing Address
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Address Line | 7815A DAVINCI LN
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City | CHARLOTTE
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State | NC
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Zip | 28226
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Country | US
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Telephone | 704-661-9580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA WRIGHT
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Credential | LPC
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Telephone | 704-661-9580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8555
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License Number State | NC
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