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General NPI Number Information
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NPI Number | 1588327464
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Entity Type | Organization
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Legal Business Name | KINDRED COUNSELING
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 322 LAMAR AVE STE 207
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City | CHARLOTTE
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State | NC
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Zip | 28204-2436
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Country | US
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Telephone | 704-793-7760
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Fax |
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Provider Business Mailing Address
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Address Line | 1519 S WENDOVER RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1725
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Country | US
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Telephone | 336-209-4227
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CONSTANCE WONG
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Credential | MA LCMHC
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Telephone | 336-793-7760
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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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