Provider Demographics
NPI:1780829697
Name:CHILDREN'S ADVOCACY CENTER OF CATAWBA COUNTY
Entity Type:Organization
Organization Name:CHILDREN'S ADVOCACY CENTER OF CATAWBA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OPDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:EXECUTIVE DIRECTOR
Authorized Official - Phone:828-465-7665
Mailing Address - Street 1:4360 COUNTY HOME ROAD
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613
Mailing Address - Country:US
Mailing Address - Phone:828-465-9296
Mailing Address - Fax:828-256-7711
Practice Address - Street 1:4360 COUNTY HOME ROAD
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613
Practice Address - Country:US
Practice Address - Phone:828-465-9296
Practice Address - Fax:828-256-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1828103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty