Organization
RESTORATIVE SUPPORT SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA FULLER (EXECUTIVE DIRECTOR)
(980) 300-7889
Entity
Organization
Contact information
Practice address
2818 QUEEN CITY DR STE E, 2818- E QUEEN CITY DRIVE, CHARLOTTE, NC 28208-2736
(704) 236-1377
Mailing address
2818 QUEEN CITY DR STE E, 2818 QUEEN CITY DRIVE SUITE E, CHARLOTTE, NC 28208-2736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
NC
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
NC
225XM0800X
Mental Health Occupational Therapist
—
NC
302R00000X
Health Maintenance Organization
—
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/30/2012
Last updated
03/31/2025
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