Healthcare Provider Details

I. General information

NPI: 1659052843
Provider Name (Legal Business Name): COMMUNITY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 FAIRMONT ST
CHARLOTTE NC
28216-5017
US

IV. Provider business mailing address

1327 FAIRMONT ST
CHARLOTTE NC
28216-5017
US

V. Phone/Fax

Practice location:
  • Phone: 302-753-2946
  • Fax:
Mailing address:
  • Phone: 302-753-2946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTINE VIRION COOK
Title or Position: FOUNDER, SPEECH PATHOLOGIST
Credential: MA, CCC-SLP
Phone: 302-753-2946