Provider Demographics
NPI:1205446556
Name:FLOYD, JUSTINA MARIE (NCC, LCMHC)
Entity type:Individual
Prefix:
First Name:JUSTINA
Middle Name:MARIE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:NCC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18145 W CATAWBA AVE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5641
Mailing Address - Country:US
Mailing Address - Phone:704-206-9810
Mailing Address - Fax:
Practice Address - Street 1:10224 HICKORYWOOD HILL AVE STE 204
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3474
Practice Address - Country:US
Practice Address - Phone:704-765-1615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-02
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
NC15979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health