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Organization
THE MENTOR NETWORK
Active
Organization
THE MENTOR NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEVAULT CLEVENGER MA LCSW (PROGRAM MANAGER)
(910) 673-3535
Entity
Organization
Contact information
Practice address
241 GRANT STREET, WEST END, NC 27376
(910) 673-3535
(901) 673-6565
Mailing address
PO BOX 310, BISCOE, NC 27209-0310
(910) 673-3535
(910) 673-6565
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005890
—
NC
Enumeration date
11/01/2006
Last updated
08/22/2020
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