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Organization
INTEGRATED CARE OF GREATER HICKORY, INC
Active
Organization
INTEGRATED CARE OF GREATER HICKORY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS DAVID BLAKEMAN RMA (CHIEF ADMINISTRATION OFFICER)
(828) 322-5915
Entity
Organization
Contact information
Practice address
741 5TH ST SW, HICKORY, NC 28602
(828) 322-5915
Mailing address
741 5TH ST SW, HICKORY, NC 28602-3230
(828) 322-5915
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
NULL
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NC
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Enumeration date
06/14/2018
Last updated
06/15/2018
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