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General NPI Number Information
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NPI Number | 1164661336
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Entity Type | Organization
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Legal Business Name | COLLECTIVE MOMENTUM COUNSELING SERVICES
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 806 AMBASSADOR ST
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City | CHARLOTTE
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State | NC
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Zip | 28208-4108
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Country | US
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Telephone | 704-737-8858
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Fax |
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Provider Business Mailing Address
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Address Line | 7435 MEADOWDALE LN
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City | CHARLOTTE
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State | NC
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Zip | 28212-4739
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DONALD MILLS
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Credential |
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Telephone | 704-737-8858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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