Provider Demographics
NPI:1457485476
Name:ESSENTIAL CONCEPTS INC.
Entity Type:Organization
Organization Name:ESSENTIAL CONCEPTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCAS, CCS, NCC
Authorized Official - Phone:336-688-6757
Mailing Address - Street 1:PO BOX 1792
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27261-1792
Mailing Address - Country:US
Mailing Address - Phone:336-688-6757
Mailing Address - Fax:
Practice Address - Street 1:2211 W MEADOWVIEW RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3409
Practice Address - Country:US
Practice Address - Phone:336-688-6757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3723251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005683Medicaid