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1154366649

NPI Code Detail

MEDICARE: SUPPORT INCORPORATED

MEDICARE: SUPPORT INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253J00000X	Foster Care Agency		NC
2	363A00000X	Physician Assistant
3	363L00000X	Nurse Practitioner
4	363LF0000X	Family Nurse Practitioner
5	251B00000X	Case Management Agency
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
7	101YA0400X	Addiction (Substance Use Disorder) Counselor
8	101YM0800X	Mental Health Counselor
9	101YP2500X	Professional Counselor
10	103T00000X	Psychologist
11	1041C0700X	Clinical Social Worker
12	106H00000X	Marriage & Family Therapist
13	2084P0800X	Psychiatry Physician
14	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154366649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPPORT INCORPORATED

Provider Business Mailing Address
First Line	:	PO BOX 4003
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-0020
Country	:	US
Telephone Number	:	704-865-3525
Fax Number	:	704-865-3520

Provider Business Practice Location Address
First Line	:	175 W FRANKLIN BLVD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28052-4145
Country	:	US
Telephone Number	:	704-865-3525
Fax Number	:	704-865-3520

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JOSH MARTIN
Credential	:
Telephone Number	:	704-865-3529

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	01/23/2024

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Practice Location Address:

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1134132756 — KARLA MCNEAL LPC
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1023184629 — THERAPEUTIC SUPPORT SERVICES
Practice Location Address:

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Directions to “SUPPORT INCORPORATED ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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