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Organization
MT AIRY THERAPY & CONSULTING SERVICES, PLLC
Active
Organization
MT AIRY THERAPY & CONSULTING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN GREGORY BAGSHAW LCSW LCAS (OWNER)
(336) 909-0192
Entity
Organization
Contact information
Practice address
200 N MAIN ST, MOUNT AIRY, NC 27030-3810
(336) 909-0192
Mailing address
1022 N MAIN ST, MOUNT AIRY, NC 27030-3636
(336) 909-0192
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
10/04/2023
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