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General NPI Number Information
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NPI Number | 1952106361
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Entity Type | Organization
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Legal Business Name | GLEE CLUB COUNSELING AND CONSULTING PLLC
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 416 MCCULLOUGH DR STE 205
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City | CHARLOTTE
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State | NC
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Zip | 28262-4392
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Country | US
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Telephone | 704-430-7686
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 BOWERY CT
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City | CHARLOTTE
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State | NC
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Zip | 28215-4199
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Country | US
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Telephone | 704-430-7686
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Fax |
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Authorized Official
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Title or Position | VOCATIONAL REHABILITATION THERAPIST
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Name | MRS. GLORIA RIOS
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Credential | LCMHC, CRC
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Telephone | 704-430-7686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 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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