Provider Demographics
NPI:1245304724
Name:COUNTY OF CATAWBA OFFICE OF ACCOUNTANT
Entity type:Organization
Organization Name:COUNTY OF CATAWBA OFFICE OF ACCOUNTANT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPELLETTY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:828-326-5960
Mailing Address - Street 1:1985 TATE BLVD SE STE 300
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-328-5960
Mailing Address - Fax:828-328-4729
Practice Address - Street 1:40 W 6TH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-3104
Practice Address - Country:US
Practice Address - Phone:828-464-0013
Practice Address - Fax:828-464-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0728UOtherBCBS NCHC
NC8301044Medicaid