# NOCD NORTH CAROLINA PC

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

## Provider details

- **NPI number:** 1114551926
- **Authorized official:** DR. MITCHELL DURHAM PH.D. (PSYCHOLOGIST)
- **Authorized official phone:** (828) 424-3773

## Contact information

- **Practice address:** 374 LAKEWIND DR, MONCKS CORNER, SC 29461-7448
- **Practice address phone:** (828) 424-3773
- **Mailing address:** 225 N MICHIGAN AVE STE 1430, CHICAGO, IL 60601-7653
- **Mailing address phone:** (312) 569-0820
- **Mailing address fax:** (312) 261-5080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/02/2020
- **Last updated:** 03/02/2020