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General NPI Number Information
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NPI Number | 1588449680
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Entity Type | Organization
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Legal Business Name | SIXBERRY COUNSELING SERVICES
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 2601 OAKCREST AVE STE F
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City | GREENSBORO
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State | NC
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Zip | 27408-4719
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Country | US
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Telephone | 336-663-1554
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Fax | 336-715-5120
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Provider Business Mailing Address
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Address Line | 2601 OAKCREST AVE STE F
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City | GREENSBORO
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State | NC
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Zip | 27408-4719
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Country | US
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Telephone | 336-663-1554
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Fax | 336-715-5120
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | MR. MATTHEW OWEN SIXBERRY
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Credential | LMFT
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Telephone | 336-663-1554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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