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General NPI Number Information
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NPI Number | 1609007566
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Entity Type | Organization
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Legal Business Name | COURAGE COUNSELING SERVICES, P.C.
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 07/27/2009
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Provider Practice Location Address
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Address Line | 1945 J N PEASE PL SUITE 204
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City | CHARLOTTE
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State | NC
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Zip | 28262-4511
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Country | US
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Telephone | 704-302-1539
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Fax | 704-593-1242
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Provider Business Mailing Address
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Address Line | 4744 ABERCROMBY ST
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City | CHARLOTTE
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State | NC
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Zip | 28213-4281
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Country | US
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Telephone | 704-302-1539
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Fax | 704-593-1242
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | STEVEN J CARMICHAEL
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Credential | MA, LPC
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Telephone | 704-605-8438
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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 | 5473
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License Number State | NC
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