Provider Demographics
NPI:1154840759
Name:NEHEMIAH CHRISTIAN COUNSELING, P.L.L.C.
Entity Type:Organization
Organization Name:NEHEMIAH CHRISTIAN COUNSELING, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ETHERIDGE
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-619-6629
Mailing Address - Street 1:303 E MAIN ST STE 9
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4452
Mailing Address - Country:US
Mailing Address - Phone:252-619-6629
Mailing Address - Fax:
Practice Address - Street 1:303 E MAIN ST STE 9
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4452
Practice Address - Country:US
Practice Address - Phone:252-619-6629
Practice Address - Fax:252-331-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NC12837101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty