Organization
MECKLENBURG COUNTY AREA MH, DD AND SA AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRAYCE CROCKETT LCSW (AREA DIRECTOR)
(704) 336-8638
Entity
Organization
Contact information
Practice address
429 BILLINGSLEY RD, CHARLOTTE, NC 28211-1007
(704) 336-2023
(704) 336-8591
Mailing address
429 BILLINGSLEY RD, CHARLOTTE, NC 28211-1007
(704) 336-2023
(704) 336-8591
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3404913
—
NC
05
—
3404913M
—
NC
05
—
3404913P
—
NC
01
—
6005609
MULTI-SPECIALTY GROUP
NC
01
—
6005610
MULTI-SPECIALTY GROUP
NC
Enumeration date
10/06/2006
Last updated
07/21/2022
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