Individual
MR. JOHN A. BASILICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
363 CHURCH ST N STE 260, CONCORD, NC 28025-4525
(980) 263-9065
Mailing address
6627 BURKWOOD CT, HARRISBURG, NC 28075-6713
(704) 299-1132
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2465
NC
101YM0800X
Mental Health Counselor
Primary
2465
NC
101YP2500X
Professional Counselor
2465
NC
Other
Enumeration date
05/29/2008
Last updated
11/20/2024
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