Healthcare Provider Details

I. General information

NPI: 1396225348
Provider Name (Legal Business Name): REAL TALK COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2128 MCCLINTOCK RD
CHARLOTTE NC
28205-5114
US

IV. Provider business mailing address

205 REGENCY EXECUTIVE PARK DR STE 210
CHARLOTTE NC
28217-2968
US

V. Phone/Fax

Practice location:
  • Phone: 980-939-0991
  • Fax: 704-731-0980
Mailing address:
  • Phone: 980-939-0991
  • Fax: 703-731-0980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberA13234
License Number StateNC

VIII. Authorized Official

Name: MRS. TAMEKA WADE BREWINGTON
Title or Position: PSYCHOTHERAPIST
Credential: MS, LCAS, CCS, LCMCH
Phone: 980-939-0991