Organization
CENTER FOR SELF GROWTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY WILLIAM NICHOLS L.C.S.W. (OWNER/CEO)
(704) 607-3324
Entity
Organization
Contact information
Practice address
144 W MOUNTAIN ST, SUITE 3, KINGS MOUNTAIN, NC 28086-3446
(704) 607-3324
(704) 675-5814
Mailing address
144 W MOUNTAIN ST, SUITE 3, KINGS MOUNTAIN, NC 28086-3446
(704) 607-3324
(704) 675-5814
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C003021
NC
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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