Provider Demographics
NPI:1154454221
Name:APPALACHIAN COUNSELING,LLC
Entity Type:Organization
Organization Name:APPALACHIAN COUNSELING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-692-7300
Mailing Address - Street 1:PO BOX 2649
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:529 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-4011
Practice Address - Country:US
Practice Address - Phone:828-883-9676
Practice Address - Fax:828-884-9753
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPALACHIAN COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-14
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101Y00000X, 101YA0400X, 101YP2500X, 1041C0700X, 106H00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301120Medicaid
NC8301120BMedicaid
NC8301121BMedicaid
NC8301121Medicaid
NC6005187Medicaid
NC8301120PMedicaid
NC8301120QMedicaid
NC8301121GMedicaid
NC8301120BMedicaid
NC8301121BMedicaid