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General NPI Number Information
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NPI Number | 1922871730
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Entity Type | Organization
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Legal Business Name | THE COUNSELING CLINIC
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 811 N MAIN STREET
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City | CREEDMOOR
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State | NC
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Zip | 27524
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Country | US
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Telephone | 919-880-5694
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 99036
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City | RALEIGH
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State | NC
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Zip | 27624-9036
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Country | US
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Telephone | 919-880-5694
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TROY T KANE
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Credential | LCMCHS
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Telephone | 919-880-5694
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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