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Individual

JOHN BRENT IDOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
102 CHESTNUT DR, HIGH POINT, NC 27262-6804
(336) 886-5594
Mailing address
804 N LAFAYETTE ST # 2, SHELBY, NC 28150-3898
(704) 476-4106

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
NC
101YM0800X
Mental Health Counselor
Primary
A18552
NC

Other

Enumeration date
08/30/2021
Last updated
04/17/2025
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