Healthcare Provider Details

I. General information

NPI: 1639616782
Provider Name (Legal Business Name): CAROLINA COUNSELING AND CONSULTING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16325 NORTHCROSS DR STE F
HUNTERSVILLE NC
28078-5044
US

IV. Provider business mailing address

531 BRENTWOOD RD # 308
DENVER NC
28037-0269
US

V. Phone/Fax

Practice location:
  • Phone: 704-266-4208
  • Fax: 866-876-6809
Mailing address:
  • Phone: 704-266-4208
  • Fax: 866-876-6809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11085
License Number StateNC

VIII. Authorized Official

Name: COURTNEY SINIARD
Title or Position: BILLING AND CREDENTIALING MANAGER
Credential:
Phone: 704-266-4208