Healthcare Provider Details

I. General information

NPI: 1053797514
Provider Name (Legal Business Name): COMPREHENSIVE COUNSELING, COACHING & CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 FRANKLIN CT
STANLEY NC
28164-9609
US

IV. Provider business mailing address

253 FRANKLIN CT
STANLEY NC
28164-9609
US

V. Phone/Fax

Practice location:
  • Phone: 704-915-2777
  • Fax:
Mailing address:
  • Phone: 704-915-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number5057
License Number StateNC

VIII. Authorized Official

Name: DR. KAREN J WILLIAMS
Title or Position: CLINICAL DIRECTOR
Credential: PSY. D, LPCS
Phone: 704-915-2777