Provider Demographics
NPI:1013051556
Name:COUNSELING INSIGHTS, INC.
Entity Type:Organization
Organization Name:COUNSELING INSIGHTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:CSAC, ICADC
Authorized Official - Phone:704-568-1122
Mailing Address - Street 1:4938 CENTRAL AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6878
Mailing Address - Country:US
Mailing Address - Phone:704-568-1122
Mailing Address - Fax:704-568-5357
Practice Address - Street 1:4938 CENTRAL AVE STE 3
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6878
Practice Address - Country:US
Practice Address - Phone:704-568-1122
Practice Address - Fax:704-568-5357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC060-461251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103106Medicaid
NC6005676Medicaid
NC6106077Medicaid