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General NPI Number Information
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NPI Number | 1790071702
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Entity Type | Organization
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Legal Business Name | PUGH COUNSELING AND CONSULTING SERVICES, INC.
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 4822 ALBEMARLE RD SUITE 100B
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City | CHARLOTTE
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State | NC
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Zip | 28205-6668
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Country | US
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Telephone | 704-451-5634
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Fax |
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Provider Business Mailing Address
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Address Line | 4822 ALBEMARLE RD SUITE 100B
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City | CHARLOTTE
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State | NC
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Zip | 28205-6668
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Country | US
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Telephone | 704-451-5634
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID ELLIS PUGH
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Credential | LPC, CRC
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Telephone | 704-451-5634
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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 | 3707
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License Number State | NC
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