Healthcare Provider Details

I. General information

NPI: 1972259059
Provider Name (Legal Business Name): MAIER COUNSELING AND PLAY THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2022
Last Update Date: 02/27/2022
Certification Date: 02/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17105 KENTON DR STE 207C
CORNELIUS NC
28031-5654
US

IV. Provider business mailing address

17105 KENTON DR STE 207C
CORNELIUS NC
28031-5654
US

V. Phone/Fax

Practice location:
  • Phone: 704-534-4283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SARAH MAIER
Title or Position: OWNER
Credential:
Phone: 704-534-4283