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NPI Code Detail

MEDICARE: TRIQUETRA COUNSELING, PLLC

MEDICARE: TRIQUETRA 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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1790435600
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIQUETRA COUNSELING, PLLC
Provider Business Mailing Address
First Line : 3926 MIRIAM DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28205-7726
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3926 MIRIAM DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28205-7726
Country : US
Telephone Number : 704-476-1580
Fax Number :
Authorized Official
Title or Position : OWNER, THERAPIST
Name : SABINA MARIA KLEIN
Credential : LCMHC
Telephone Number : 704-476-1580
Provider Enumeration Date : 03/24/2022
Last Update Date : 03/24/2022

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Directions to “TRIQUETRA COUNSELING, PLLC ” Practice Location

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