Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YM0800X | Mental Health Counselor | 12968 | NC |
N | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor |
NPI | 1205261443 |
---|---|
Provider Name | Mr. Elliot Sanchez |
First Address | Gastonia, NC 28052-4358 |
Second Address | Gastonia, NC 28052-4312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2013 |
Last Update Date | 23/09/2020 |