Provider Demographics
NPI:1407539992
Name:REDEFINED COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:REDEFINED COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,LCAS,CCS
Authorized Official - Phone:252-594-8907
Mailing Address - Street 1:600 PLAZA BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1600
Mailing Address - Country:US
Mailing Address - Phone:253-560-8387
Mailing Address - Fax:
Practice Address - Street 1:600 PLAZA BLVD STE E
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1600
Practice Address - Country:US
Practice Address - Phone:253-560-8387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty