Provider Demographics
NPI:1619000825
Name:CATAWBA COUNTY OFFICE OF ACCOUNTANT
Entity Type:Organization
Organization Name:CATAWBA COUNTY OFFICE OF ACCOUNTANT
Other - Org Name:FAMILY NET OF CATAWBA COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPELLETTY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:828-326-5960
Mailing Address - Street 1:1985 TATE BLVD SE STE 300
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-326-5960
Mailing Address - Fax:828-328-4729
Practice Address - Street 1:1985 TATE BLVD SE STE 300
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1433
Practice Address - Country:US
Practice Address - Phone:828-326-5960
Practice Address - Fax:828-328-4729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMH-018-0032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900831Medicaid