Healthcare Provider Details

I. General information

NPI: 1124950696
Provider Name (Legal Business Name): MY COMFY COUCH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6172 LITTLE MOUNTAIN RD
SHERRILLS FORD NC
28673
US

IV. Provider business mailing address

1422 E MAIN ST # 126
LINCOLNTON NC
28092-3902
US

V. Phone/Fax

Practice location:
  • Phone: 980-389-4291
  • Fax: 980-389-4291
Mailing address:
  • Phone: 980-389-4291
  • Fax: 980-389-4291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY AMY LYNN COOPER
Title or Position: SOLE MEMBER
Credential: LCAS, LCMHC, CSI
Phone: 980-389-4291