Healthcare Provider Details

I. General information

NPI: 1861205312
Provider Name (Legal Business Name): GILDED PEACE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CORPORATE CENTER CT STE B
GREENSBORO NC
27408-3839
US

IV. Provider business mailing address

7 CORPORATE CENTER CT STE B
GREENSBORO NC
27408-3839
US

V. Phone/Fax

Practice location:
  • Phone: 336-223-6069
  • Fax:
Mailing address:
  • Phone: 336-223-6069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIA HUNTER
Title or Position: OWNER
Credential: LCMHC, LPCC, CCTP
Phone: 336-223-6069