# GASTON CLINICAL HEALTH CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gaston Clinical Health Center PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639956659
- **Authorized official:** MRS. ROXANN T THOMAS LCAS (DIRECTOR/OWNER)
- **Authorized official phone:** (704) 297-6111

## Contact information

- **Practice address:** 305 S COLUMBIA ST, GASTONIA, NC 28054-0451
- **Practice address phone:** (704) 297-6111
- **Practice address fax:** (704) 565-4299
- **Mailing address:** 5457 SPINDLE RIDGE LN, GASTONIA, NC 28056-8515
- **Mailing address phone:** (704) 297-6111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 09/12/2023
- **Last updated:** 08/18/2024