Organization
INNOVATIVE CONCEPTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADINE ROBERTS LCMHC (CEO)
(704) 533-5168
Entity
Organization
Contact information
Practice address
9625 DAVID TAYLOR DR # 120A, CHARLOTTE, NC 28262-2362
(704) 533-5168
Mailing address
133 WEAVERS GLENN PL, CHARLOTTE, NC 28262-1698
(704) 533-5168
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A12126
NC
Other
Enumeration date
06/23/2016
Last updated
03/11/2024
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