Provider Demographics
NPI:1710275391
Name:GREAT EXPECTATIONS COUNSELING SERVICES
Entity Type:Organization
Organization Name:GREAT EXPECTATIONS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCIE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:HARTSOG-DOLACK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:704-724-3525
Mailing Address - Street 1:903 NORTHEAST DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7416
Mailing Address - Country:US
Mailing Address - Phone:704-724-3525
Mailing Address - Fax:
Practice Address - Street 1:903 NORTHEAST DR
Practice Address - Street 2:SUITE 101
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-7416
Practice Address - Country:US
Practice Address - Phone:704-724-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7907101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104647Medicaid