MEDICARE: YOUR COMMUNITY COUNSELING AND INTEGRATED SUPPORTS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	172V00000X	Community Health Worker
2	374J00000X	Doula
3	101YA0400X	Addiction (Substance Use Disorder) Counselor
4	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1346195641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR COMMUNITY COUNSELING AND INTEGRATED SUPPORTS

Provider Business Mailing Address
First Line	:	521 YOPP RD STE 214-308
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-3595
Country	:	US
Telephone Number	:	980-355-2260
Fax Number	:	833-837-7903

Provider Business Practice Location Address
First Line	:	521 YOPP RD STE 214-308
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-3595
Country	:	US
Telephone Number	:	980-355-2260
Fax Number	:	833-837-7903

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	LAUREN DORNELL-NEAL
Credential	:	LCMHC, LCAS, LCPC,
Telephone Number	:	980-355-2260

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	06/08/2026

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