Provider Demographics
NPI:1477357549
Name:ICENHOUR THERAPY. PLLC
Entity type:Organization
Organization Name:ICENHOUR THERAPY. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ICENHOUR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-719-7559
Mailing Address - Street 1:242 NETTLE KNOB RD
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-7257
Mailing Address - Country:US
Mailing Address - Phone:828-719-7559
Mailing Address - Fax:
Practice Address - Street 1:242 NETTLE KNOB RD
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694-7257
Practice Address - Country:US
Practice Address - Phone:828-719-7559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty