Organization
A SAFE PLACE EMPOWERMENT NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WANDA JONES LCSW, LCSA, PHD (PROVIDER)
(929) 451-4290
Entity
Organization
Contact information
Practice address
260 W MAIN AVE STE A, GASTONIA, NC 28052-4166
(929) 451-4290
(704) 802-1631
Mailing address
260 W MAIN AVE STE A, GASTONIA, NC 28052-4166
(704) 498-8898
(704) 802-1631
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
12/09/2022
Last updated
02/12/2025
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