Provider Demographics
NPI:1265515969
Name:CLEVELAND COUNTY SCHOOLS
Entity type:Organization
Organization Name:CLEVELAND COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR LIAISON
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:HALL
Authorized Official - Last Name:PUTNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LPC
Authorized Official - Phone:704-472-3896
Mailing Address - Street 1:105 E RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-3034
Mailing Address - Country:US
Mailing Address - Phone:704-476-8000
Mailing Address - Fax:704-476-8304
Practice Address - Street 1:105 E RIDGE ST
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3034
Practice Address - Country:US
Practice Address - Phone:704-476-8000
Practice Address - Fax:704-476-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8600034Medicaid