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NPI Code Detail

MEDICARE: SANDHILLS COUNSELING ASSOCIATES, PLLC

MEDICARE: SANDHILLS COUNSELING ASSOCIATES, 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
1101YM0800XMental Health Counselor7412NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LPC7412OTHERNCLPC LICENSE

General Provider Information

NPI Number : 1427470301
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANDHILLS COUNSELING ASSOCIATES, PLLC
Provider Business Mailing Address
First Line : 49 GUILFORD CT
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-7058
Country : US
Telephone Number : 910-987-6342
Fax Number : 910-436-2070
Provider Business Practice Location Address
First Line : 810 CHAPEL HILL RD
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-2140
Country : US
Telephone Number : 910-916-7881
Fax Number : 910-436-2070
Authorized Official
Title or Position : OWNER
Name : DR. CHAUNTEL M SUMMERS
Credential : PHD
Telephone Number : 910-916-7881
Provider Enumeration Date : 01/13/2014
Last Update Date : 01/13/2014

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