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Organization
OUR TREATMENT CENTER
Active
Organization
OUR TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TASHA HOLLAND-KORNEGAY PHD, LPC (OWNER)
(919) 601-1313
Entity
Organization
Contact information
Practice address
4909 WATERS EDGE DR, 104, RALEIGH, NC 27606-2462
(919) 601-1313
Mailing address
1702 SHERIFF WATSON RD, SANFORD, NC 27332-6720
(919) 601-1313
(919) 267-9079
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7134
NC
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6008508
—
NC
Enumeration date
01/14/2011
Last updated
07/11/2022
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