Provider Demographics
NPI:1568657955
Name:CLINICAL AND CONSULTING SOLUTIONS PLLC
Entity Type:Organization
Organization Name:CLINICAL AND CONSULTING SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:EFIRD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LCAS
Authorized Official - Phone:704-433-8064
Mailing Address - Street 1:604 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-5131
Mailing Address - Country:US
Mailing Address - Phone:704-433-8064
Mailing Address - Fax:704-932-0170
Practice Address - Street 1:243A TOWN CENTRE DR
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-8001
Practice Address - Country:US
Practice Address - Phone:704-433-8064
Practice Address - Fax:704-781-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0050041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106214Medicaid