Provider Demographics
NPI:1548431992
Name:COUNSELING & CONSULTING PROFESSIONALS OF NC, PLLC
Entity Type:Organization
Organization Name:COUNSELING & CONSULTING PROFESSIONALS OF NC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M. LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-770-7743
Mailing Address - Street 1:7318 RIDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-9155
Mailing Address - Country:US
Mailing Address - Phone:704-770-7743
Mailing Address - Fax:
Practice Address - Street 1:7318 RIDGEFIELD DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-9155
Practice Address - Country:US
Practice Address - Phone:704-770-7743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0055951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty