Provider Demographics
NPI:1639738073
Name:PARTNERS AGAINST SEXUALLY TRANSMITTED DISEASES
Entity Type:Organization
Organization Name:PARTNERS AGAINST SEXUALLY TRANSMITTED DISEASES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND-KORNEGAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPCS
Authorized Official - Phone:919-601-1313
Mailing Address - Street 1:1702 SHERIFF WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-6720
Mailing Address - Country:US
Mailing Address - Phone:919-601-1313
Mailing Address - Fax:
Practice Address - Street 1:717 N HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-3517
Practice Address - Country:US
Practice Address - Phone:919-601-1313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty