Organization · NPI-2

2nd II None Foundation

Counselor, Mental Health · Charlotte, NC

NPI number1114001088
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1114001088
Entity type
Organization (NPI-2)
Legal business name
2nd II None Foundation
Organization subpart
No
Enumeration date
Oct 25, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health6005700NCYes

Practice location

5820 E Wt Harris Blvd
Suite 111
Charlotte, NC 28215-3541

Phone 704-566-6134 · Fax 704-566-6136

Mailing address

Po Box 480794
Charlotte, NC 28269-5323

Phone 704-566-6134 · Fax 704-566-6136

Authorized official

Thomas Scott Corbett
Clinical Director
7045666134

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