Organization
GREENE MCILWAINE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATASHA MCILWAINE EDD, LCMHCS, LCAS (PRESIDENT)
(704) 340-4666
Entity
Organization
Contact information
Practice address
615 E 6TH ST, CHARLOTTE, NC 28202-2918
(704) 492-1105
Mailing address
PO BOX 743, PAW CREEK, NC 28130-0743
(704) 340-4666
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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