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Individual
MR. REZELL GORE
Active
Individual
MR. REZELL GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, LCAS, CCS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-20470
NC
101YM0800X
Mental Health Counselor
C010441
NC
1041C0700X
Clinical Social Worker
Primary
C010441
NC
Other
Enumeration date
09/09/2014
Last updated
02/11/2022
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