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General NPI Number Information
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NPI Number | 1457895724
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Entity Type | Organization
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Legal Business Name | INNER COMPASS COUNSELING, COACHING, CONSULTING PLLC
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Dates
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Enumeration Date | 12/06/2016
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 19428 FRIDLEY LN
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City | CORNELIUS
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State | NC
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Zip | 28031-9041
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Country | US
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Telephone | 704-492-0713
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Fax |
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Provider Business Mailing Address
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Address Line | 19428 FRIDLEY LN
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City | CORNELIUS
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State | NC
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Zip | 28031-9041
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Country | US
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Telephone | 704-492-0713
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GERALD CHRISTOPHER BROWN
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Credential | PHD
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Telephone | 704-492-0713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10326
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License Number State | NC
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