Provider Demographics
NPI:1043072143
Name:BETH C KINCAID MED NCC LCMHC PLLC
Entity type:Organization
Organization Name:BETH C KINCAID MED NCC LCMHC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:KINCAID
Authorized Official - Suffix:
Authorized Official - Credentials:MED, NCC, LCMHC
Authorized Official - Phone:336-450-0606
Mailing Address - Street 1:301 S ELM ST STE 311
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2636
Mailing Address - Country:US
Mailing Address - Phone:336-450-0606
Mailing Address - Fax:336-450-1596
Practice Address - Street 1:301 S ELM ST STE 311
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2636
Practice Address - Country:US
Practice Address - Phone:336-450-0606
Practice Address - Fax:336-450-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty