Organization
THERAPEUTIC INTERVENTION GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLTON GUNNING (OWNER)
(704) 927-9695
Entity
Organization
Contact information
Practice address
1100 S MINT ST, SUITE 108, CHARLOTTE, NC 28203-4049
(704) 927-9695
Mailing address
1100 S MINT ST, SUITE 108, CHARLOTTE, NC 28203-4049
(704) 927-9695
(704) 927-9697
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/20/2011
Last updated
09/21/2011
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