Healthcare Provider Details

I. General information

NPI: 1295662633
Provider Name (Legal Business Name): KINDRED CONNECTIONS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 BRUSSELS CT
WALKERTOWN NC
27051-9546
US

IV. Provider business mailing address

6010 BRUSSELS CT
WALKERTOWN NC
27051-9546
US

V. Phone/Fax

Practice location:
  • Phone: 336-365-2867
  • Fax:
Mailing address:
  • Phone: 336-365-2867
  • 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: OLIVIA D EASLEY
Title or Position: MANAGING OWNER
Credential: PHD LCMHC QS
Phone: 561-401-3408