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NPI Code Detail

MEDICARE: CROWNED FOR THIS COUNSELING AND CONSULTING PLLC

MEDICARE: CROWNED FOR THIS 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1528765302
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROWNED FOR THIS COUNSELING AND CONSULTING PLLC
Provider Business Mailing Address
First Line : 125 REMOUNT RD STE C1
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6459
Country : US
Telephone Number : 704-610-2752
Fax Number :
Provider Business Practice Location Address
First Line : 125 REMOUNT RD STE C1
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6459
Country : US
Telephone Number : 704-610-2752
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LAURIE FORD
Credential : LCMHC
Telephone Number : 704-430-0516
Provider Enumeration Date : 02/13/2023
Last Update Date : 07/10/2023

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