Provider Demographics
NPI:1407103617
Name:PREMIERE COUNSELING PROFESSIONALS
Entity Type:Organization
Organization Name:PREMIERE COUNSELING PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARRISSE
Authorized Official - Middle Name:TREMAINE
Authorized Official - Last Name:SOMME
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-978-5783
Mailing Address - Street 1:8025 N POINT BLVD
Mailing Address - Street 2:SUITE 256
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3262
Mailing Address - Country:US
Mailing Address - Phone:336-306-5334
Mailing Address - Fax:336-771-3025
Practice Address - Street 1:8025 N POINT BLVD
Practice Address - Street 2:SUITE 256
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3262
Practice Address - Country:US
Practice Address - Phone:336-306-5334
Practice Address - Fax:336-771-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4464251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health