Provider Demographics
NPI:1831237056
Name:ACCESSIBLE PSCYHOLOGCIAL COUNSELING SERVICES, PC
Entity type:Organization
Organization Name:ACCESSIBLE PSCYHOLOGCIAL COUNSELING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:EH
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:704-535-5831
Mailing Address - Street 1:3623 LATROBE DR
Mailing Address - Street 2:STE 103
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4864
Mailing Address - Country:US
Mailing Address - Phone:704-535-5831
Mailing Address - Fax:704-364-4141
Practice Address - Street 1:PO BOX 18153
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28218-0153
Practice Address - Country:US
Practice Address - Phone:704-535-5831
Practice Address - Fax:704-364-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2009-07-01
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2009-07-01
Provider Licenses
StateLicense IDTaxonomies
NC3252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty