Provider Demographics
NPI:1356743678
Name:TOGETHER WE STAND
Entity type:Organization
Organization Name:TOGETHER WE STAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TEAL
Authorized Official - Middle Name:GARVIN
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LISW
Authorized Official - Phone:704-449-9666
Mailing Address - Street 1:5736 N TRYON ST
Mailing Address - Street 2:105
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-6850
Mailing Address - Country:US
Mailing Address - Phone:888-502-9591
Mailing Address - Fax:888-502-9591
Practice Address - Street 1:922 N LOGAN ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-2002
Practice Address - Country:US
Practice Address - Phone:888-502-9591
Practice Address - Fax:888-502-9591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSW10561041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSW1056Medicaid