Provider Demographics
NPI:1053053611
Name:NOVA LUX COUNSELING
Entity Type:Organization
Organization Name:NOVA LUX COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD, MS, LPC
Authorized Official - Phone:475-289-0884
Mailing Address - Street 1:101 N TRYON ST STE 112
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28246-0104
Mailing Address - Country:US
Mailing Address - Phone:475-237-4575
Mailing Address - Fax:866-213-3606
Practice Address - Street 1:101 N TRYON ST STE 112
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28246-0104
Practice Address - Country:US
Practice Address - Phone:475-237-4575
Practice Address - Fax:866-213-3606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty