MEDICARE: INCEPTION COUNSELING SERVICES 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1669135810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCEPTION COUNSELING SERVICES PLLC

Provider Business Mailing Address
First Line	:	1633 NEW GARDEN RD # 440
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-2001
Country	:	US
Telephone Number	:	336-890-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 CORPORATE CENTER CT STE B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-3839
Country	:	US
Telephone Number	:	336-890-6900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHAVIS JERARD DELOATCH
Credential	:	LCMHC
Telephone Number	:	252-532-7084

Provider Enumeration Date	:	10/14/2021
Last Update Date	:	03/08/2026

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