=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871474239
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SABLE COUNSELING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2025
-----------------------------------------------------
Last Update Date | 09/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6241 SOUTH BOULEVARD UNIT 242112
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-524-2267
-----------------------------------------------------
Fax | 704-559-2426
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6241 SOUTH BOULEVARD UNIT 242112
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-524-2267
-----------------------------------------------------
Fax | 704-559-2426
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MELINDA PADMORE
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 757-524-2267
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------