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General NPI Number Information
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NPI Number | 1780119792
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Entity Type | Individual
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Provider Name | KIERRA MUNDINE M.S, LCMHC
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Gender | Female
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 2507 PINNIX ST # A
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City | GREENSBORO
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State | NC
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Zip | 27405-7336
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Country | US
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Telephone | 252-631-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N MURROW BLVD # 68
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City | GREENSBORO
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State | NC
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Zip | 27401-2914
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Country | US
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Telephone | 252-631-0049
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 18254
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License Number State | NC
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