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NPI Code Detail

MEDICARE: AGAPE CREATIVE MINISTRIES

MEDICARE: AGAPE CREATIVE MINISTRIES
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
1101YP2500XProfessional CounselorA12285NC
2106H00000XMarriage & Family Therapist11050ANC

General Provider Information

NPI Number : 1871949651
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGAPE CREATIVE MINISTRIES
Provider Business Mailing Address
First Line : 2124 CROWN CENTRE DR STE 400
Second Line :
City : CHARLOTTE
State : NC
Zip : 28227-7804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2124 CROWN CENTRE DR STE 400
Second Line :
City : CHARLOTTE
State : NC
Zip : 28227-7804
Country : US
Telephone Number : 704-849-0144
Fax Number : 704-845-1611
Authorized Official
Title or Position : EXECUTIVE DIRECTOR/THERAPIST
Name : JENNIFER H DEAN
Credential :
Telephone Number : 704-849-0144
Provider Enumeration Date : 05/10/2016
Last Update Date : 05/10/2016

Similar Medicare Providers

1659440469 — AGAPE CREATIVE MINISTRIES, INC.
Practice Location Address:
2124 CROWN CENTRE DR , SUITE 400
CHARLOTTE, NC
28227-7804
Practice Phone: 704-849-0144
Practice Fax: 704-845-1611
1821308263 — BELINDA H. JOHNSON M.A., L.M.F.T.A.
Practice Location Address:
2124 CROWN CENTRE DR STE 400
CHARLOTTE, NC
28227-7804
Practice Phone: 704-849-0144
Practice Fax:
1194113159 — AGAPE CREATIVE MINISTRIES, INC. DBA AGAPE CHRISTIAN COUNSELING
Practice Location Address:
2124 CROWN CENTRE DR STE 400
CHARLOTTE, NC
28227-7804
Practice Phone: 704-849-0144
Practice Fax: 704-845-1611
1194113084 — DR. VINCENT COSTA DR.
Practice Location Address:
2124 CROWN CENTRE DR STE 400
CHARLOTTE, NC
28227-7804
Practice Phone: 704-849-0144
Practice Fax:
1154840882 — KAITLYN RAE FRASER I MA, LPCA
Practice Location Address:
2124 CROWN CENTRE DR STE 400
CHARLOTTE, NC
28227-7804
Practice Phone: 704-849-0144
Practice Fax:
1750937264 — CRYSTAL DAWN MURPHY
Practice Location Address:
2124 CROWN CENTRE DR STE 400
CHARLOTTE, NC
28227-7804
Practice Phone: 704-849-0144
Practice Fax:

Directions to “AGAPE CREATIVE MINISTRIES ” Practice Location

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