Provider Demographics
NPI:1699026674
Name:ALLIANCE THERAPY GROUP PLLC
Entity Type:Organization
Organization Name:ALLIANCE THERAPY GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS LCAS CCMHC
Authorized Official - Phone:704-334-3444
Mailing Address - Street 1:1801 EAST FIFTH ST.
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3400
Mailing Address - Country:US
Mailing Address - Phone:704-334-3444
Mailing Address - Fax:704-334-3499
Practice Address - Street 1:1801 EAST FIFTH ST.
Practice Address - Street 2:SUITE 203
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3400
Practice Address - Country:US
Practice Address - Phone:704-334-3444
Practice Address - Fax:704-334-3499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPCSS4536101YM0800X
NCLPC9117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty