Provider Demographics
NPI:1851623110
Name:PRUDEN COUNSELING CONCEPTS PLLC
Entity Type:Organization
Organization Name:PRUDEN COUNSELING CONCEPTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEISCHA
Authorized Official - Middle Name:HOLLEY
Authorized Official - Last Name:PRUDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-331-3135
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-0325
Mailing Address - Country:US
Mailing Address - Phone:252-332-3135
Mailing Address - Fax:252-332-2416
Practice Address - Street 1:101 MAIN ST W
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3301
Practice Address - Country:US
Practice Address - Phone:252-332-3135
Practice Address - Fax:252-332-2416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health