# 2ND II NONE FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114001088
- **Authorized official:** MR. THOMAS SCOTT CORBETT MA, LMHC, LPC, NCC (CLINICAL DIRECTOR)
- **Authorized official phone:** (704) 566-6134

## Contact information

- **Practice address:** 5820 E WT HARRIS BLVD, SUITE 111, CHARLOTTE, NC 28215-3541
- **Practice address phone:** (704) 566-6134
- **Practice address fax:** (704) 566-6136
- **Mailing address:** PO BOX 480794, CHARLOTTE, NC 28269-5323
- **Mailing address phone:** (704) 566-6134
- **Mailing address fax:** (704) 566-6136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 6005700 | NC | Yes |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 08/22/2020