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General NPI Number Information
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NPI Number | 1710665351
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Entity Type | Organization
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Legal Business Name | SOLID ROCK LLC
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 4919 ALBEMARLE RD STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28205-6653
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Country | US
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Telephone | 704-777-6132
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Fax |
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Provider Business Mailing Address
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Address Line | 7114 AGAVA LN
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City | CHARLOTTE
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State | NC
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Zip | 28215-7168
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Country | US
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Telephone | 980-213-9471
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACI ATKINS
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Credential |
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Telephone | 980-213-9471
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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