Provider Demographics
NPI:1891280517
Name:ASHEVILLE COMMUNITY THERAPY CENTER, PLLC
Entity Type:Organization
Organization Name:ASHEVILLE COMMUNITY THERAPY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:AGNES
Authorized Official - Last Name:VANDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:828-273-4852
Mailing Address - Street 1:959 MERRIMON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-2466
Mailing Address - Country:US
Mailing Address - Phone:828-273-4852
Mailing Address - Fax:828-658-0056
Practice Address - Street 1:959 MERRIMON AVE STE 101
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2466
Practice Address - Country:US
Practice Address - Phone:828-273-4852
Practice Address - Fax:828-658-0056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5744235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty