Organization
INTEGRATED BEHAVIORAL HEALTH MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN CATHERINE RICHARDSON (DIRECTOR)
(704) 910-6142
Entity
Organization
Contact information
Practice address
8430 MEDICAL PLAZA DR STE 300, CHARLOTTE, NC 28262-9758
(704) 910-6142
(980) 422-0106
Mailing address
8430 MEDICAL PLAZA DR STE 300, CHARLOTTE, NC 28262-9758
(704) 910-6142
(908) 422-0106
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
5004974
NC
261QM0850X
Adult Mental Health Clinic/Center
5004974
NC
261QM0855X
Adolescent and Children Mental Health Clinic/Center
5004974
NC
261QP2300X
Primary Care Clinic/Center
5004974
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
01/26/2024
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