MINDGATE BEHAVIORAL SPECIALISTS NPI 1962932822

NPI Information

NPI: 1962932822
Provider Name: MINDGATE BEHAVIORAL SPECIALISTS

Former Legal Business Name: INCLUSION COUNSELING SERVICES, LLC.

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
803 TAYLOR AVE
HIGH POINT, NC
ZIP 27260
Phone: (336) 689-3444
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MINDGATE BEHAVIORAL SPECIALISTS is an addiction (substance use disorder) counselor in High Point, NC. MINDGATE BEHAVIORAL SPECIALISTS NPI is 1962932822. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Inclusion Counseling Services, Llc..

The provider's business location address is:

803 TAYLOR AVE
HIGH POINT, NC
ZIP 27260-369
Phone: (336) 689-3444
Fax: (336) 886-1421

The provider's authorized official is Sylvester R Smith .
The authorized official title is Owner and has the following contact phone number (336) 689-3444.

The enumeration date for this NPI number is 6/14/2017 and was last updated on 1/18/2023.

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			No
2	225XM0800X	Occupational Therapist	Mental Health	S8977	NORTH CAROLINA	No
3	251S00000X	Community/Behavioral Health				No
4	101YA0400X	Counselor	Addiction (Substance Use Disorder)	20131	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6115154	MEDICAID	NORTH CAROLINA

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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