Provider Demographics
NPI:1154809879
Name:COHESIVE COUNSELING ASSOCIATES PLLC
Entity type:Organization
Organization Name:COHESIVE COUNSELING ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR, CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:E
Authorized Official - Last Name:TATE-SCRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD-LPCS
Authorized Official - Phone:704-957-8568
Mailing Address - Street 1:7427 MATTHEWS MINT HILL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7863
Mailing Address - Country:US
Mailing Address - Phone:704-957-3865
Mailing Address - Fax:704-910-3542
Practice Address - Street 1:2210 CORONATION BLVD
Practice Address - Street 2:STE C
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-6799
Practice Address - Country:US
Practice Address - Phone:704-957-3865
Practice Address - Fax:704-910-3542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS9529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty