Provider Demographics
NPI:1932821329
Name:MCWHORTER, INDIA S (LCMHCA)
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:S
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PARKER FEIMSTER LN
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28678-9138
Mailing Address - Country:US
Mailing Address - Phone:828-832-6116
Mailing Address - Fax:
Practice Address - Street 1:4030 WAKE FOREST RD STE 349
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-0010
Practice Address - Country:US
Practice Address - Phone:980-858-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health