Organization
MINDGATE BEHAVIORAL SPECIALISTS
Active
Other names
Inclusion Counseling Services, LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SYLVESTER R SMITH MSRC, LCMHCS, LCAS (OWNER)
(336) 689-3444
Entity
Organization
Contact information
Practice address
803 TAYLOR AVE, HIGH POINT, NC 27260-7369
(336) 689-3444
(336) 886-1421
Mailing address
803 TAYLOR AVE, HIGH POINT, NC 27260-7369
(336) 689-3444
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20131
NC
101YM0800X
Mental Health Counselor
—
—
225XM0800X
Mental Health Occupational Therapist
S8977
NC
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6115154
—
NC
Enumeration date
06/14/2017
Last updated
01/18/2023
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