Individual
MS. KATHLEEN MARY GOMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CAS
Contact information
Practice address
120 COASTAL HORIZONS DR, SHALLOTTE, NC 28470-6094
(910) 754-4515
Mailing address
1919 STONE BALLAST WAY, OCEAN ISLE BEACH, NC 28469
(910) 754-3782
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
349
NC
101YM0800X
Mental Health Counselor
S3928
NC
106H00000X
Marriage & Family Therapist
000227
CT
106H00000X
Marriage & Family Therapist
930
NC
Other
Enumeration date
01/10/2007
Last updated
09/21/2012
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