Provider Demographics
NPI:1245826411
Name:ASSUAGE COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:ASSUAGE COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHINIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSWA
Authorized Official - Phone:704-792-8406
Mailing Address - Street 1:11 UNION ST S STE 208
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1004
Mailing Address - Country:US
Mailing Address - Phone:704-792-8406
Mailing Address - Fax:
Practice Address - Street 1:11 UNION ST S STE 208
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1004
Practice Address - Country:US
Practice Address - Phone:704-792-8406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty