Provider Demographics
NPI:1770946832
Name:H.I.S COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:H.I.S COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:KILGORE
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-421-8290
Mailing Address - Street 1:2443 CHERRY RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2172
Mailing Address - Country:US
Mailing Address - Phone:704-421-8290
Mailing Address - Fax:
Practice Address - Street 1:2703 FOREST GROVE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1034
Practice Address - Country:US
Practice Address - Phone:704-421-8290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty