Provider Demographics
NPI:1003108200
Name:CARING HEARTS PROFESSIONAL COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:CARING HEARTS PROFESSIONAL COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-299-0848
Mailing Address - Street 1:P. O. BOX 1734
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28329
Mailing Address - Country:US
Mailing Address - Phone:910-299-0848
Mailing Address - Fax:910-299-0850
Practice Address - Street 1:312 COLLEGE ST
Practice Address - Street 2:SUITE C
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4181
Practice Address - Country:US
Practice Address - Phone:910-299-0848
Practice Address - Fax:910-299-0850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 251S00000X
NC2064101YA0400X
NC7604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty