Provider Demographics
NPI:1114388808
Name:FINISH PLLC
Entity Type:Organization
Organization Name:FINISH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:ANISE
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-A, LCAS-A
Authorized Official - Phone:860-888-6058
Mailing Address - Street 1:5307 FIRELIGHT LN
Mailing Address - Street 2:UNIT G
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2209
Mailing Address - Country:US
Mailing Address - Phone:860-888-6058
Mailing Address - Fax:704-910-3803
Practice Address - Street 1:5307 FIRELIGHT LN
Practice Address - Street 2:UNIT G
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2209
Practice Address - Country:US
Practice Address - Phone:860-888-6058
Practice Address - Fax:704-910-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP009306251S00000X
NC20099251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health