Provider Demographics
NPI:1588060693
Name:COUNSELING CONCEPTS GROUP LLC
Entity type:Organization
Organization Name:COUNSELING CONCEPTS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-409-7423
Mailing Address - Street 1:317 RUTH VISTA RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-8628
Mailing Address - Country:US
Mailing Address - Phone:910-409-7423
Mailing Address - Fax:
Practice Address - Street 1:317 RUTH VISTA RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-8628
Practice Address - Country:US
Practice Address - Phone:910-409-7423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health