Individual
DIRK NUTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCA, LCAS-A, CRC
Contact information
Practice address
6324 STONEWICK DR, JAMESTOWN, NC 27282-8516
(336) 707-6825
Mailing address
6324 STONEWICK DR, JAMESTOWN, NC 27282-8516
(336) 707-6825
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-20573
NC
101YM0800X
Mental Health Counselor
A10631
NC
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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