NPI 1346979093 · live from the CMS NPI Registry
A Divine Time LLC
Clinic/Center, Adult Mental Health in Charlotte, NC. National Provider Identifier 1346979093, active.
NPI record
| NPI | 1346979093 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Adult Mental Health 261QM0850X |
| Practice location | 8539 Monroe Rd # 123, Charlotte, NC 28212 |
| Practice phone | 336-541-3485 |
| Mailing address | 8539 Monroe Rd Ste 123, Charlotte, NC 28212 |
| Enumerated | June 8, 2022 |
| Last updated | October 10, 2022 |
| Authorized official | Tressa Corbett, Administrator |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Counselor | 101Y00000X | — |
| Counselor, Mental Health | 101YM0800X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Peer Specialist | 175T00000X | — |
| Family Medicine | 207Q00000X | — |
| Family Medicine, Addiction Medicine | 207QA0401X | — |
| Family Medicine, Adult Medicine | 207QA0505X | — |
| Clinic/Center | 261Q00000X | — |
| Clinic/Center, Mental Health (Including Community Mental Health Center) | 261QM0801X | — |
| Clinic/Center, Adolescent and Children Mental Health | 261QM0855X | — |
| Clinic/Center, Adult Mental Health primary | 261QM0850X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.