Provider Demographics
NPI:1467897736
Name:DANIELLE KINCAID
Entity Type:Organization
Organization Name:DANIELLE KINCAID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACT TEAM LEADER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KINCAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-433-1909
Mailing Address - Street 1:400 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3678
Mailing Address - Country:US
Mailing Address - Phone:828-433-1909
Mailing Address - Fax:
Practice Address - Street 1:400 S GREEN ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3678
Practice Address - Country:US
Practice Address - Phone:828-433-1909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9018251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health