Provider Demographics
NPI:1609588227
Name:NOTHING BUT GRACE NBG COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:NOTHING BUT GRACE NBG COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORGANIZER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNERLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:980-430-9256
Mailing Address - Street 1:9311 JW CLAY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-5411
Mailing Address - Country:US
Mailing Address - Phone:980-430-9256
Mailing Address - Fax:
Practice Address - Street 1:1436 RUMSTONE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4217
Practice Address - Country:US
Practice Address - Phone:980-430-9256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty