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General NPI Number Information
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NPI Number | 1932433893
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Entity Type | Organization
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Legal Business Name | MCWILLIAMS CENTER FOR COUNSELING
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 936 N MARIETTA ST
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City | GASTONIA
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State | NC
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Zip | 28054-7301
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Country | US
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Telephone | 704-686-7001
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Fax | 704-852-4401
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Provider Business Mailing Address
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Address Line | 936 N MARIETTA ST
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City | GASTONIA
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State | NC
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Zip | 28054-7301
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Country | US
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Telephone | 704-686-7001
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Fax | 704-852-4401
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Authorized Official
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Title or Position | CFO
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Name | TANESHIA MCKINSTRY
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Credential |
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Telephone | 704-686-7001
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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 |
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License Number State |
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Taxonomy #2
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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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