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Organization

180 BEHAVIORAL HEALTH, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH WARREN DICKSON MA, LPC, NCC (CLINICAL SUPERVISOR/OWNER)
(828) 268-4022
Entity
Organization

Contact information

Practice address
496 MORNINGSIDE DR., BLOWING ROCK, NC 28605
(828) 268-4022
Mailing address
PO BOX 1645, BLOWING ROCK, NC 28605-1645
(828) 268-4022

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
4632
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6102765
NC
Enumeration date
08/28/2008
Last updated
08/28/2008
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