Provider Demographics
NPI:1245869700
Name:DYNAMIC SOLUTIONS CENTER FOR COUNSELING, PLLC
Entity type:Organization
Organization Name:DYNAMIC SOLUTIONS CENTER FOR COUNSELING, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:K
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-923-2000
Mailing Address - Street 1:PO BOX 2186
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-6186
Mailing Address - Country:US
Mailing Address - Phone:704-214-7237
Mailing Address - Fax:855-306-2963
Practice Address - Street 1:307 E KING ST STE A
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3492
Practice Address - Country:US
Practice Address - Phone:704-214-7237
Practice Address - Fax:855-306-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-06
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
12620074OtherCAQH