Provider Demographics
NPI:1750736302
Name:WARREN, KADIA REMI (LPC)
Entity type:Individual
Prefix:
First Name:KADIA
Middle Name:REMI
Last Name:WARREN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 ROSHNI TER
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9802
Mailing Address - Country:US
Mailing Address - Phone:336-587-5046
Mailing Address - Fax:
Practice Address - Street 1:8025 N POINT BLVD STE 209
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106
Practice Address - Country:US
Practice Address - Phone:866-700-1606
Practice Address - Fax:888-338-5921
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12308101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional