Healthcare Provider Details

I. General information

NPI: 1285080671
Provider Name (Legal Business Name): ZOLA COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6813 FAIRVIEW RD STE C
CHARLOTTE NC
28210-3364
US

IV. Provider business mailing address

6813 FAIRVIEW RD STE C
CHARLOTTE NC
28210-3364
US

V. Phone/Fax

Practice location:
  • Phone: 980-428-6195
  • Fax: 704-220-2366
Mailing address:
  • Phone: 980-428-6195
  • Fax: 704-220-2366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC008773
License Number StateNC

VIII. Authorized Official

Name: REBEKAH SPEARS TALLEY
Title or Position: OWNER, THERAPIST
Credential: MSW, LCSW
Phone: 704-970-3902