=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124739644
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUE ASPIRATION COUNSELING PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2022
-----------------------------------------------------
Last Update Date | 12/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8501 TOWER POINT DR # B34
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28227-7849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-294-0965
-----------------------------------------------------
Fax | 980-294-0966
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8501 TOWER POINT DR # B34
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28227-7849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-294-0965
-----------------------------------------------------
Fax | 980-294-0966
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CARLOS PROCTOR
-----------------------------------------------------
Credential | LCMHC
-----------------------------------------------------
Telephone | 980-294-0965
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------