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General NPI Number Information
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NPI Number | 1073079505
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Entity Type | Organization
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Legal Business Name | COURAGE TO CHANGE COUNSELING LLC
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 402 ALAMANCE RD STE E
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City | BURLINGTON
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State | NC
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Zip | 27215-6176
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Country | US
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Telephone | 919-548-7125
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Fax |
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Provider Business Mailing Address
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Address Line | 402 ALAMANCE RD STE E
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City | BURLINGTON
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State | NC
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Zip | 27215-6176
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Country | US
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Telephone | 919-548-7125
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MRS. CAROLINE COURTNEY JONES
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Credential | LCAS
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Telephone | 919-548-7125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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