Organization
BAKER COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY IRONSIDE HAYNES LCMHC (OWNER)
(704) 762-7400
Entity
Organization
Contact information
Practice address
611 SULLIVAN RD, STATESVILLE, NC 28677-3437
(704) 762-7400
Mailing address
611 SULLIVAN RD, STATESVILLE, NC 28677-3437
(704) 762-7400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/10/2016
Last updated
04/03/2024
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