Provider Demographics
NPI:1043921034
Name:COMPLEMENT AND COMPLETE, PLLC
Entity type:Organization
Organization Name:COMPLEMENT AND COMPLETE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCSW-C
Authorized Official - Phone:910-216-4655
Mailing Address - Street 1:4800 EXPRESS DR.
Mailing Address - Street 2:#19769 SMB#29685
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208
Mailing Address - Country:US
Mailing Address - Phone:910-216-4655
Mailing Address - Fax:
Practice Address - Street 1:2041 BUCKHILL ROAD
Practice Address - Street 2:
Practice Address - City:GERRARDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25420-2542
Practice Address - Country:US
Practice Address - Phone:951-264-0369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1700338886OtherNPI