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NPI Code Detail

MEDICARE: ELLEN KINSER LCMHC

MEDICARE: ELLEN KINSER LCMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLPC 88447NC
2101YP2500XProfessional Counselor8447NC

General Provider Information

NPI Number : 1043553530
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN KINSER LCMHC
Provider Business Mailing Address
First Line : 20668 SPRING GROVE LN
Second Line :
City : CORNELIUS
State : NC
Zip : 28031-8524
Country : US
Telephone Number : 980-680-9286
Fax Number :
Provider Business Practice Location Address
First Line : 3705 LATROBE DR STE 340
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-4823
Country : US
Telephone Number : 704-364-3989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2013
Last Update Date : 07/19/2024

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Directions to “ ELLEN KINSER LCMHC” Practice Location

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