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Organization

CAROLINA CENTER FOR COUNSELING & CLINICAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LYNN HAMMONTREE BA (FINANCE DIRECTOR)
(704) 861-2234
Entity
Organization

Contact information

Practice address
227 WILMOT DR, GASTONIA, NC 28054-4048
(704) 861-2234
(704) 861-2235
Mailing address
PO BOX 550178, GASTONIA, NC 28055-0178
(704) 861-2234
(704) 861-2235

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6005311
NC
05
6102411
NC
05
6103191
NC
05
6104029
NC
05
6104153
NC
05
6115044
NC
05
8300211
NC
05
8300211S
NC
Enumeration date
11/01/2006
Last updated
10/28/2020
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