Provider Demographics
NPI:1629384391
Name:MCPHERSON, NATIKA MONIQUE (PHD, LPCS, NCC, ACS)
Entity Type:Individual
Prefix:DR
First Name:NATIKA
Middle Name:MONIQUE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:PHD, LPCS, NCC, ACS
Other - Prefix:
Other - First Name:NATIKA
Other - Middle Name:MONIQUE
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2715 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-4193
Mailing Address - Country:US
Mailing Address - Phone:980-236-1868
Mailing Address - Fax:
Practice Address - Street 1:2715 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-4193
Practice Address - Country:US
Practice Address - Phone:980-236-1868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9598101YP2500X
NC8187S101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
278368OtherNATIONAL CERTIFIED COUNSELOR
NC6104556Medicaid