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Organization

ELITE ADOLESCENT CARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BARSHEEM CHAPMAN (CEO)
(910) 483-0324
Entity
Organization

Contact information

Practice address
4501 OLD BATTLEGROUND RD, GREENSBORO, NC 27410-9352
(910) 483-0324
(910) 483-2246
Mailing address
111 LAMON ST, SUITE 103, FAYETTEVILLE, NC 28301-4901
(910) 483-0324
(910) 483-2246

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YS0200X
School Counselor
103T00000X
Psychologist
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
103TC1900X
Counseling Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
103TP0016X
Prescribing (Medical) Psychologist
1041C0700X
Clinical Social Worker
1041S0200X
School Social Worker
106H00000X
Marriage & Family Therapist
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6008846
NC
Enumeration date
09/23/2013
Last updated
09/23/2013
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