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General NPI Number Information
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NPI Number | 1740407774
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Entity Type | Organization
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Legal Business Name | FAMILY OUTREACH&COUNSELINGCENTER
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | FAMILY OUTREACH& COUNSELING CENTER INC 700PARKWOOD AVE 304
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City | CHARLOTTE
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State | NC
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Zip | 28205
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Country | US
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Telephone | 704-333-2033
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Fax |
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Provider Business Mailing Address
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Address Line | FAMILY OUTREACH& COUNSELING CENTER INC 700PARKWOOD AVE 304
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City | CHARLOTTE
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State | NC
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Zip | 28205
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Country | US
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Telephone | 704-333-2033
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DONA M PATTERSON
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Credential | LMFT
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Telephone | 704-333-2033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 306
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License Number State | NC
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