# GANTT YOUTH AND FAMILY SERVICES LLC

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

## Provider details

- **NPI number:** 1235692419
- **Authorized official:** TOMEKA GANTT LPC (THERAPIST)
- **Authorized official phone:** (704) 968-4893

## Contact information

- **Practice address:** 9635 SOUTHERN PINE BLVD STE 127, CHARLOTTE, NC 28273-5563
- **Practice address phone:** (704) 968-4893
- **Practice address fax:** (704) 583-0672
- **Mailing address:** 10234 KELSO CT, CHARLOTTE, NC 28278-6637
- **Mailing address phone:** (704) 968-4893
- **Mailing address fax:** (704) 583-0672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/13/2019
- **Last updated:** 04/13/2019