Healthcare Provider Details

I. General information

NPI: 1912155474
Provider Name (Legal Business Name): ASHEBORO COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S COX ST STE B
ASHEBORO NC
27203-5791
US

IV. Provider business mailing address

350 S COX ST STE B
ASHEBORO NC
27203-5791
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-3151
  • Fax: 336-625-0301
Mailing address:
  • Phone: 336-625-3151
  • Fax: 336-625-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM NELSON GARROT
Title or Position: MANAGER
Credential: MA, LPC, LCSW
Phone: 336-625-3151