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NPI Profile for RESTORE HEALTHCARE MEDICAL GROUP in CHARLOTTE, NC.
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master?s degree and clinical experience and supervision for licensure or certification.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Counselor |
101Y00000X | |||
Case Management |
251B00000X | |||
Case Manager/Care Coordinator |
171M00000X | |||
Community/Behavioral Health |
251S00000X | |||
Day Training, Developmentally Disabled Services |
251C00000X | |||
Developmental Disabilities |
261QD1600X | |||
Early Intervention Provider Agency |
252Y00000X | |||
Environmental Modification |
224ZE0001X | |||
In Home Supportive Care |
253Z00000X | |||
Occupational Medicine |
261QX0100X | |||
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine | |
Physical Therapy |
261QP2000X | |||
Rehabilitation |
261QR0400X | B4[14] | Rehabilitation Agency | |
Respite Care, Intellectual and/or Developmental Disabilities |
385HR2060X | |||
Speech-Language Pathologist |
235Z00000X | 15 | Speech Language Pathologist |
| NPI # | 1184120750 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/03/2018 | |
| Last updated | 10/28/2021 - About 5 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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RESTORE HEALTHCARE MEDICAL GROUP
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| NICOLE BRYANT 5104 REAGAN DR CHARLOTTE, NC |
| KATHY W HEATLEY, LCMHC 2701 STATESVILLE AVE CHARLOTTE, NC |
| YOLANDA I REQUENA SILLA, MD CALLE GALEON 2, BAJO A MAJADAHONDA, MADRID |
| NICOLE B NEWELL, LPC P.O. BOX 26663 CHARLOTTE, NC |
| DNA THERAPY AND CREATIVE SOLUTIONS 101 N TRYON STREET CHARLOTTE, NC |
RESTORE HEALTHCARE MEDICAL GROUP