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Organization

INTEGRATIVE THERAPEUTIC COUNSELING SERVICES

Active
Other names
Integrative Therapeutic Counseling Services
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHEENA ILEAN HASTY LCASA-23287 (CEO)
(540) 320-2859
Entity
Organization

Contact information

Practice address
1101 TYVOLA RD STE 218, CHARLOTTE, NC 28217-3515
(540) 320-2859
Mailing address
607 PINE TREE ES DR, SALISBURY, NC 28144-0517
(540) 320-2859

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992985972
NC
Enumeration date
11/13/2018
Last updated
11/13/2018
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