<Unavail>

LBN: Kingdom Creative Counseling Pllc
<Unavail> is an health care organization with primary practice located at 1050 Revolution Mill Dr Ste 2 , Greensboro NC 27405-5053. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Kingdom Creative Counseling Pllc can be contacted via phone (336) 543-0159, or through Colbert, Samaria M via phone (336) 543-0159.

Contact Information

Primary practice address
1050 Revolution Mill Dr Ste 2 Greensboro NC 27405-5053
Phone: (336) 543-0159
Fax: (336) 663-2906
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Samaria M Licensed Clinical Social Worker (LCSW)
Phone: (336) 543-0159

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C007049 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X C007049 North Carolina

Profile Details

NPI number 1700313780
LBN Legal business name Kingdom Creative Counseling Pllc
DBA Doing business as <Unavail>
Authorized official Colbert, Samaria M Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date May 22nd, 2017
Last updated Dec 18th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700313780 NPPES
North Carolina MEDICAID 1699077396

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