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General NPI Number Information
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NPI Number | 1730385527
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Entity Type | Organization
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Legal Business Name | REW WORKS COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 8430 UNIVERSITY EXECUTIVE PARK DR SUITE 608
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City | CHARLOTTE
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State | NC
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Zip | 28262
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Country | US
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Telephone | 704-593-1106
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 561132
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City | CHARLOTTE
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State | NC
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Zip | 28256-1132
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Country | US
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Telephone | 704-593-1106
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | DESIREE REW
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Credential | LCSW
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Telephone | 704-593-1106
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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 | C004146
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License Number State | NC
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