Organization
2ND II NONE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS SCOTT CORBETT MA, LMHC, LPC, NCC (CLINICAL DIRECTOR)
(704) 566-6134
Entity
Organization
Contact information
Practice address
5820 E WT HARRIS BLVD, SUITE 111, CHARLOTTE, NC 28215-3541
(704) 566-6134
(704) 566-6136
Mailing address
PO BOX 480794, CHARLOTTE, NC 28269-5323
(704) 566-6134
(704) 566-6136
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6005700
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005700
—
NC
Enumeration date
10/25/2006
Last updated
08/22/2020
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