Provider Demographics
NPI: | 1952002966 |
---|---|
Name: | EQUIP COUNSELING & CONSULTING, PLLC |
Entity type: | Organization |
Organization Name: | EQUIP COUNSELING & CONSULTING, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO/OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TENISHA |
Authorized Official - Middle Name: | NICOLE |
Authorized Official - Last Name: | MCLEAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCMHCS |
Authorized Official - Phone: | 336-303-8854 |
Mailing Address - Street 1: | 7 CORPORATE CENTER CT STE B |
Mailing Address - Street 2: | |
Mailing Address - City: | GREENSBORO |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27408-3839 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-303-8854 |
Mailing Address - Fax: | 336-203-3450 |
Practice Address - Street 1: | 810 CANNONADE DR |
Practice Address - Street 2: | |
Practice Address - City: | WHITSETT |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27377-8010 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-303-8854 |
Practice Address - Fax: | 336-203-3450 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-03-15 |
Last Update Date: | 2024-12-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |