Organization
GREENWOOD COUNSELING CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE LANE KURTZ LPC (OWNER)
(704) 682-0384
Entity
Organization
Contact information
Practice address
132 JOE KNOX AVE STE 100E, MOORESVILLE, NC 28117-9203
(704) 360-3641
(704) 353-7944
Mailing address
132 JOE KNOX AVE STE 100E, MOORESVILLE, NC 28117-9203
(704) 360-3641
(704) 353-7944
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/10/2017
Last updated
03/25/2019
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