Provider Demographics
NPI:1306144910
Name:AHSAT COUNSELING AND CONSULTING. PLLC
Entity type:Organization
Organization Name:AHSAT COUNSELING AND CONSULTING. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:MICHELLE QUAILES
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-999-7378
Mailing Address - Street 1:8340 ROLLING MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3353
Mailing Address - Country:US
Mailing Address - Phone:704-999-7378
Mailing Address - Fax:
Practice Address - Street 1:13420 REESE BLVD W
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7925
Practice Address - Country:US
Practice Address - Phone:704-999-7378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-05
Last Update Date:2011-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC266251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106903Medicaid
NC6106903Medicaid