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Organization
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Active
Organization
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Active
Parent organization
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Other names
Clinical Social Work
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Authorized official
MARILYN TATHAM (PROVIDER ENROLLMENT MANAGER)
(828) 651-6595
Entity
Organization
Contact information
Practice address
428 BILTMORE AVE, ASHEVILLE, NC 28801-4502
(828) 213-1740
Mailing address
PO BOX 603366, CHARLOTTE, NC 28260-3366
(828) 213-1500
(828) 681-1575
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02CG9
BC/BS OF NC
NC
Enumeration date
11/29/2018
Last updated
11/30/2018
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