MEDICARE: CLEMONS COUNSELING AND CONSULTING 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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1457212631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEMONS COUNSELING AND CONSULTING PLLC

Provider Business Mailing Address
First Line	:	10643 KETTERING DRIVE
Second Line	:	SUITE 108
City	:	CHARLOTTE
State	:	NC
Zip	:	28226
Country	:	US
Telephone Number	:	704-284-9570
Fax Number	:	980-470-6780

Provider Business Practice Location Address
First Line	:	10643 KETTERING DRIVE
Second Line	:	SUITE 108
City	:	CHARLOTTE
State	:	NC
Zip	:	28226
Country	:	US
Telephone Number	:	704-284-9570
Fax Number	:	980-470-6780

Authorized Official
Title or Position	:	COUNSELOR
Name	:	MR. STEVEN LLOYD CLEMONS JR.
Credential	:	LCMHCS, LMFT
Telephone Number	:	704-284-9570

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	12/11/2025

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