Provider Demographics
NPI:1063491744
Name:PETER KRONESPHD,PA
Entity Type:Organization
Organization Name:PETER KRONESPHD,PA
Other - Org Name:MONROE COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONES
Authorized Official - Suffix:I
Authorized Official - Credentials:DR
Authorized Official - Phone:704-289-2228
Mailing Address - Street 1:1201 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-3026
Mailing Address - Country:US
Mailing Address - Phone:704-289-2228
Mailing Address - Fax:704-291-7150
Practice Address - Street 1:1201 MILLER ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3026
Practice Address - Country:US
Practice Address - Phone:704-289-2228
Practice Address - Fax:704-291-7150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3661101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC023658OtherVMC
NC6005126Medicaid
NC133U5OtherBC/BS