Organization
MY THERAPY NC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY ASHLEY WEASE LCMHCS, LCAS, CCS (OWNER)
(704) 300-6922
Entity
Organization
Contact information
Practice address
2579 HARRIS HENRIETTA RD., MOORESBORO, NC 28114
(704) 300-6922
Mailing address
PO BOX 425, HENRIETTA, NC 28076-0425
(704) 300-6922
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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