Healthcare Provider Details

I. General information

NPI: 1629957097
Provider Name (Legal Business Name): PIVOT COUNSELING AND CONSULTING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1382 DOWDEN ST
KERNERSVILLE NC
27284-0107
US

IV. Provider business mailing address

1382 DOWDEN ST
KERNERSVILLE NC
27284-0107
US

V. Phone/Fax

Practice location:
  • Phone: 704-980-2858
  • Fax:
Mailing address:
  • Phone: 704-980-2858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS JAMERA MCQUEEN
Title or Position: OWNER
Credential: MS, MHA
Phone: 704-980-2858