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General NPI Number Information
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NPI Number | 1306144910
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Entity Type | Organization
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Legal Business Name | AHSAT COUNSELING AND CONSULTING. PLLC
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Dates
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Enumeration Date | 03/05/2011
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Last Update Date | 03/05/2011
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Provider Practice Location Address
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Address Line | 13420 REESE BLVD W
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7925
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Country | US
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Telephone | 704-999-7378
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Fax |
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Provider Business Mailing Address
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Address Line | 8340 ROLLING MEADOWS LN
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3353
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Country | US
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Telephone | 704-999-7378
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | LATASHA MICHELLE QUAILES ELLIS
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Credential | LCSW
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Telephone | 704-999-7378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 266
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License Number State | NC
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