# CABIN VILLAGE AND ASSOCIATES, LLC

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

## Provider details

- **NPI number:** 1194462747
- **Authorized official:** CLINTON EDWARDS LCSW (OWNER)
- **Authorized official phone:** (276) 728-6703

## Contact information

- **Practice address:** 1151 W LEBANON ST STE 200, MOUNT AIRY, NC 27030-2225
- **Practice address phone:** (276) 728-6703
- **Mailing address:** 1015 ROCKFORD ST STE 200, MOUNT AIRY, NC 27030-5026
- **Mailing address phone:** (276) 728-6703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2022
- **Last updated:** 06/11/2022