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General NPI Number Information
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NPI Number | 1780282715
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Entity Type | Organization
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Legal Business Name | LAKE NORMAN MIND AND BODY CONNECTION PLLC
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 16507 NORTHCROSS DR STE C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-5082
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Country | US
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Telephone | 704-396-4287
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Fax |
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Provider Business Mailing Address
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Address Line | 16507 NORTHCROSS DR STE C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-5082
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Country | US
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Telephone | 704-396-4287
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER S PEARCE
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Credential | MA, LCMHC
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Telephone | 704-396-4287
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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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