Organization
KINGSPOINTE BEHAVIORAL HEALTHCARE SERVICES, LLC
Active
Other names
Kingspointe Academy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LLRAE SCOTT B.S., QMHP (EXECUTIVEDIRECTORCLINICALSERVICES)
(704) 487-6226
Entity
Organization
Contact information
Practice address
201 W MARION ST, SUITE 207, SHELBY, NC 28150-5091
(704) 487-6226
(704) 487-6286
Mailing address
201 W MARION ST, SUITE 207, SHELBY, NC 28150-5091
(704) 487-6226
(704) 487-6286
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2260
NC
101YM0800X
Mental Health Counselor
5595
NC
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-023-046
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-023-128
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-055-090
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-055-091
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418018
—
NC
05
—
6005943
—
NC
05
—
6603801
—
NC
05
—
6603802
—
NC
05
—
6604071
—
NC
05
—
6604075
—
NC
05
—
8300864
—
NC
05
—
8300864B
—
NC
05
—
8300864G
—
NC
05
—
8300864H
—
NC
Enumeration date
02/06/2007
Last updated
01/09/2008
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