Organization
COMMUNITY INNOVATIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY ANDERSON (CEO PRESIDENT)
(910) 739-8849
Entity
Organization
Contact information
Practice address
2003 GODWIN AVE, SUITE A, LUMBERTON, NC 28358-3197
(910) 739-8849
(919) 739-8698
Mailing address
2003 GODWIN AVE, SUITE A, LUMBERTON, NC 28358-3197
(910) 739-8849
(919) 739-8698
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NC
101YP2500X
Professional Counselor
Primary
—
NC
1041C0700X
Clinical Social Worker
—
NC
171M00000X
Case Manager/Care Coordinator
—
—
2084P0800X
Psychiatry Physician
—
NC
Other
Enumeration date
11/09/2006
Last updated
04/29/2009
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