Organization
MERIDIAN SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY SUBER (DIRECTOR)
(704) 289-4084
Entity
Organization
Contact information
Practice address
1880 CONCORD AVE STE C, MONROE, NC 28110-3060
(910) 207-6421
Mailing address
1880 CONCORD AVE STE C, MONROE, NC 28110-3060
(910) 207-6421
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
A11668
NC
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043692809
—
NC
Enumeration date
06/29/2015
Last updated
05/25/2022
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