INNOVATIVE COMMUNITY RESOURCES NC INC NPI 1326249434

NPI Information

NPI: 1326249434
Provider Name: INNOVATIVE COMMUNITY RESOURCES NC INC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
5736 N TRYON ST STE 200
CHARLOTTE, NC
ZIP 28213
Phone: (704) 921-6777
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INNOVATIVE COMMUNITY RESOURCES NC INC is a mental health counselor in Charlotte, NC. INNOVATIVE COMMUNITY RESOURCES NC INC NPI is 1326249434. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5736 N TRYON ST STE 200
CHARLOTTE, NC
ZIP 28213-820
Phone: (704) 921-6777
Fax: (704) 509-2220

The provider's authorized official is Loretta I Tillman .
The authorized official title is Executive Clinical Director and has the following contact phone number (704) 921-6777.

The enumeration date for this NPI number is 5/29/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	3411	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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