Provider Demographics
NPI:1407373293
Name:LDH COUNSELING & CONSULTING PLLC
Entity Type:Organization
Organization Name:LDH COUNSELING & CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MS, LCMHC, LCAS-A/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:NICHOLETTE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMHC, LCAS-A
Authorized Official - Phone:704-419-3760
Mailing Address - Street 1:213 PATTON DR STE B
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-4696
Mailing Address - Country:US
Mailing Address - Phone:704-419-3760
Mailing Address - Fax:704-419-3760
Practice Address - Street 1:213 PATTON DR STE B
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4696
Practice Address - Country:US
Practice Address - Phone:980-465-2533
Practice Address - Fax:704-419-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11893101YP2500X, 261QM0850X
101YP2500X
NC22796261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11893OtherLPC
NC22796OtherLCAS-A