Provider Demographics
NPI:1134224546
Name:COUNSELING CENTER OF GREENSBORO
Entity type:Organization
Organization Name:COUNSELING CENTER OF GREENSBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEREL
Authorized Official - Middle Name:H
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:336-543-8123
Mailing Address - Street 1:2309 W CONE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4044
Mailing Address - Country:US
Mailing Address - Phone:336-543-8123
Mailing Address - Fax:336-282-3445
Practice Address - Street 1:2309 W CONE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4044
Practice Address - Country:US
Practice Address - Phone:336-543-8123
Practice Address - Fax:336-282-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5207101YM0800X
261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005184Medicaid
2315582AMedicare ID - Type Unspecified
NC6005184Medicaid