Provider Demographics
NPI:1245002914
Name:RELEASE COUNSELING CENTER PLLC
Entity type:Organization
Organization Name:RELEASE COUNSELING CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MADELINE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:980-260-8437
Mailing Address - Street 1:800 ROBINSON RD STE D
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-8851
Mailing Address - Country:US
Mailing Address - Phone:980-260-8437
Mailing Address - Fax:
Practice Address - Street 1:800 ROBINSON RD STE D
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8851
Practice Address - Country:US
Practice Address - Phone:980-260-8437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty