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NPI Code Detail

MEDICARE: DOGWOOD COUNSELING PLLC

MEDICARE: DOGWOOD COUNSELING PLLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional Counselor
3106H00000XMarriage & Family Therapist
41041C0700XClinical Social Worker

General Provider Information

NPI Number : 1407204837
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOGWOOD COUNSELING PLLC
Provider Business Mailing Address
First Line : 3600 CHEVINGTON RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-4931
Country : US
Telephone Number : 704-617-0756
Fax Number :
Provider Business Practice Location Address
First Line : 6813 FAIRVIEW RD STE D
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3364
Country : US
Telephone Number : 704-617-0756
Fax Number : 704-870-3966
Authorized Official
Title or Position : OWNER
Name : SARAH COOPER
Credential : LCSW, LCAS
Telephone Number : 704-617-0756
Provider Enumeration Date : 05/26/2016
Last Update Date : 02/15/2019

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