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General NPI Number Information
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NPI Number | 1811168057
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Entity Type | Individual
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Provider Name | CASSANDRA KORNEGAY COLSON LPC, ATR-BC, CSW
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Gender | Female
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Dates
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Enumeration Date | 03/16/2008
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Last Update Date | 03/16/2008
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Provider Practice Location Address
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Address Line | 4530 SE SCHOOL RD
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City | GREENSBORO
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State | NC
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Zip | 27406-9784
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Country | US
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Telephone | 336-674-4300
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Fax | 336-674-4290
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Provider Business Mailing Address
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Address Line | PO BOX 431 691 SCARLETT CT
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City | HIGH POINT
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State | NC
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Zip | 27261-0431
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Country | US
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Telephone | 336-883-9389
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 4236
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License Number State | NC
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