=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679617815
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTERNATIONAL INSTITUTE FOR CRITICAL THINKING INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 408 STATE ST STATE STREET CENTER FOR RENEWAL
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27405-5657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-707-8866
-----------------------------------------------------
Fax | 336-294-0904
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 ANDREW PAUL WAY
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27410-4185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-707-8866
-----------------------------------------------------
Fax | 336-294-0904
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. GERHARD MICHAEL KROISS
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 336-707-8866
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 3497
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------