Healthcare Provider Details

I. General information

NPI: 1639090715
Provider Name (Legal Business Name): CHARLOTTE COUNSELING COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 MATTHEWS MINT HILL RD STE 108
MATTHEWS NC
28105-2894
US

IV. Provider business mailing address

317 MATTHEWS MINT HILL RD STE 108
MATTHEWS NC
28105-2894
US

V. Phone/Fax

Practice location:
  • Phone: 704-654-6508
  • Fax:
Mailing address:
  • Phone: 704-654-6508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SAVANNAH BRYANT
Title or Position: COUNSELOR, CO-OWNER
Credential: LCMHC, NCC
Phone: 704-771-5849