Provider Demographics
NPI:1114568722
Name:TRUE CONNECTIONS COUNSELING SERVICE
Entity Type:Organization
Organization Name:TRUE CONNECTIONS COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRENTISS
Authorized Official - Middle Name:C
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-747-1189
Mailing Address - Street 1:6534 OVERLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9691
Mailing Address - Country:US
Mailing Address - Phone:480-747-1189
Mailing Address - Fax:
Practice Address - Street 1:504 E CORNWALLIS DR STE R
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5678
Practice Address - Country:US
Practice Address - Phone:480-747-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty