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Support Incorporated

Community/Behavioral Health in Gastonia, NC. Organization (NPI-2).

NPI number1780974253
StatusActive
Last updated in NPPESDec 30, 2015

Details

NPI
1780974253
Entity type
Organization (NPI-2)
Legal business name
Support Incorporated
Organization subpart
No
Enumeration date
Apr 18, 2011
Last updated
Dec 30, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral HealthMHL-036-292NCYes
261QP2300X Clinic/Center, Primary Care––
261QM1300X Clinic/Center, Multi-Specialty––
101YA0400X Counselor, Addiction (Substance Use Disorder)––
101YM0800X Counselor, Mental Health––
101YP2500X Counselor, Professional––
103T00000X Psychologist––
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry––
363L00000X Nurse Practitioner––
363LF0000X Nurse Practitioner, Family––
363LP0808X Nurse Practitioner, Psych/Mental Health––
363A00000X Physician Assistant––
1041C0700X Social Worker, Clinical––

Practice location

708 S Chestnut St
Gastonia, NC 28054-4548

Phone 704-865-3525 · Fax 704-865-3520

Mailing address

Po Box 4003
Gastonia, NC 28054-0041

Phone 704-865-3525 · Fax 704-865-3520

Authorized official

Josh Martin
Executive Director
7048653529

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