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Organization
PHOENIX COUNSELING OF GASTON LINCOLN
Active
Organization
PHOENIX COUNSELING OF GASTON LINCOLN
Active
Other names
Phoenix Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN P OLIVER MA MPA (EXECUTIVE DIRECTOR)
(704) 921-3070
Entity
Organization
Contact information
Practice address
917 1ST ST, SHELBY, NC 28150-3958
(704) 921-3070
(704) 921-3066
Mailing address
4007 WILD NURSERY CT, CHARLOTTE, NC 28215-5345
(704) 921-3070
(704) 921-3066
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NC
101YM0800X
Mental Health Counselor
—
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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