Organization
PIEDMONT BEHAVIORAL RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANZY BARROW WALLACE (CEO)
(704) 487-6226
Entity
Organization
Contact information
Practice address
201 W. MARION ST. STE. 207, SHELBY, NC 28150
(704) 487-6226
(704) 487-6286
Mailing address
201 W. MARION ST. STE. 207, SHELBY, NC 28150
(704) 487-6226
(704) 487-6286
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1135
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
229
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
366
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
MHL-023-148
NC
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
5595
NC
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
NC
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-023-046
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418626
—
NC
05
—
6006639
—
NC
05
—
6603420
—
NC
05
—
6604374
—
NC
05
—
6604390
—
NC
05
—
8302555
—
NC
05
—
8302555Q
—
NC
Enumeration date
08/20/2008
Last updated
03/26/2013
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