Basic Information
| Provider Information | |||||||||
| NPI: | 1629356720 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SCOTLAND FAMILY COUNSELING CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1603-A MEDICAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283525541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102767011 | ||||||||
| FaxNumber: | 9102767060 | ||||||||
| Practice Location | |||||||||
| Address1: | 1603-A MEDICAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283525541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102767011 | ||||||||
| FaxNumber: | 9102767060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2011 | ||||||||
| LastUpdateDate: | 08/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | WENTZ | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
| AuthorizedOfficialMiddleName: | JAMES | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9102767011 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | LPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.