National Provider Identifier

Into The Wild, Inc.

Into The Wild, Inc. is listed in the NPPES registry with a primary specialty of Addiction (Substance Use Disorder) Counselor in Lewisville, NC and a listed phone number of (336) 314-0051.

NPI 1023775541Lewisville, NCAddiction (Substance Use Disorder) Counselor

Source: public NPPES record, last updated November 18, 2021. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.

Profile Overview

NPI
1023775541
Provider Type
Organization
Primary Specialty
Addiction (Substance Use Disorder) Counselor
Enumeration Date
November 18, 2021
Last Updated
November 18, 2021

Practice Location

  • 5765 Shallowford RD
  • Lewisville, NC 27023-9610

Phone: (336) 314-0051

Mailing Address

  • PO Box 1291
  • King, NC 27021-1291

Authorized Official

Name
Dr. Max Goelling
Title
Cfo
Credentials
PHD
Phone
(336) 314-0051

Specialties

  • Addiction (Substance Use Disorder) Counselor (101YA0400X)

Endpoints

  • www.intothewildhelps.org

    Connect Url | Health Information Exchange (Hie) | Other | Lewisville, NC 27023

    Primary Website

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Full Record
NPI
1023775541
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Into The Wild, Inc.
Mailing Street Address
PO Box 1291
Mailing City
King
Mailing State
NC
Mailing ZIP Code
27021-1291
Mailing Country
US
Mailing Phone
(336) 314-0051
Practice Street Address
5765 Shallowford RD
Practice City
Lewisville
Practice State
NC
Practice ZIP Code
27023-9610
Practice Country
US
Practice Phone
(336) 314-0051
Enumeration Date
November 18, 2021
Last Updated
November 18, 2021
Authorized Official Last Name
Goelling
Authorized Official First Name
Max
Authorized Official Title
Cfo
Authorized Official Phone
(336) 314-0051
Organization Subpart
No
Authorized Official Name Prefix Text
Dr.
Authorized Official Credential Text
PHD
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
November 18, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Addiction (Substance Use Disorder) Counselor (101YA0400X)