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Organization
MENTOR BEHAVIORAL HEALTHCARE & ASSOCIATES
Active
Organization
MENTOR BEHAVIORAL HEALTHCARE & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG BOWMAN MCKINNEY LCSW (MANAGER)
(828) 773-3887
Entity
Organization
Contact information
Practice address
249 WILSON DR STE 5, BOONE, NC 28607-8782
(828) 268-2172
(877) 211-7323
Mailing address
249 WILSON DR STE 5, BOONE, NC 28607-8782
(828) 268-2172
(877) 211-7323
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2555
NC
103TC2200X
Clinical Child & Adolescent Psychologist
2555
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
2555
NC
1041C0700X
Clinical Social Worker
Primary
C01375
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006175
—
NC
Enumeration date
11/27/2017
Last updated
06/16/2018
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