Healthcare Provider Details

I. General information

NPI: 1851057533
Provider Name (Legal Business Name): PEACEFUL PLACE CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 SARDIS RD N STE 207
CHARLOTTE NC
28270-3000
US

IV. Provider business mailing address

1811 SARDIS RD N STE 207
CHARLOTTE NC
28270-3000
US

V. Phone/Fax

Practice location:
  • Phone: 704-228-3377
  • Fax:
Mailing address:
  • Phone: 704-228-3377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. GALINA OLIVERA-CELDRAN
Title or Position: OWNER & THERAPIST
Credential: PHD, LCMHCS
Phone: 704-228-3377