MEDICARE: INNER STRENGTH COUNSELING SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C006232	NC
2	101YP2500X	Professional Counselor	C006232	NC
3	102L00000X	Psychoanalyst	C006232	NC
4	1041S0200X	School Social Worker	C006232	NC
5	1041C0700X	Clinical Social Worker	C006232	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2853448B	OTHER	NC	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699090662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER STRENGTH COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	3139 AMITY CT
Second Line	:	200
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-4934
Country	:	US
Telephone Number	:	704-566-3633
Fax Number	:	704-288-4391

Provider Business Practice Location Address
First Line	:	3139 AMITY CT
Second Line	:	200
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-4934
Country	:	US
Telephone Number	:	704-566-3633
Fax Number	:	704-288-4391

Authorized Official
Title or Position	:	OWNER/CLINICAL DIRECTOR
Name	:	ROBYN REEVES CODRINGTON
Credential	:	MSW, LCSW
Telephone Number	:	704-566-3633

Provider Enumeration Date	:	04/02/2010
Last Update Date	:	08/30/2011

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Directions to “INNER STRENGTH COUNSELING SERVICES ” Practice Location

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