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General NPI Number Information
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NPI Number | 1699333203
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Entity Type | Organization
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Legal Business Name | COSBY COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 1554 UNION RD STE B
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City | GASTONIA
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State | NC
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Zip | 28054-5581
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Country | US
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Telephone | 980-522-8061
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Fax |
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Provider Business Mailing Address
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Address Line | 8525 LONG CREEK CLUB DR APT 101
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City | CHARLOTTE
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State | NC
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Zip | 28216-2899
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Country | US
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Telephone | 704-733-7207
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Fax | 704-749-8742
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Authorized Official
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Title or Position | OWNER
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Name | MS. DEANNA COSBY
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Credential | LCMHCS
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Telephone | 704-953-6259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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