Provider Demographics
NPI:1457895724
Name:INNER COMPASS COUNSELING, COACHING, CONSULTING PLLC
Entity Type:Organization
Organization Name:INNER COMPASS COUNSELING, COACHING, CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-492-0713
Mailing Address - Street 1:19428 FRIDLEY LN
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-9041
Mailing Address - Country:US
Mailing Address - Phone:704-492-0713
Mailing Address - Fax:
Practice Address - Street 1:19428 FRIDLEY LN
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-9041
Practice Address - Country:US
Practice Address - Phone:704-492-0713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GERALD BROWN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty