Provider Demographics
NPI:1831911346
Name:NOURISHED CONNECTIONS COUNSELING
Entity type:Organization
Organization Name:NOURISHED CONNECTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:SIMONE
Authorized Official - Last Name:WHYTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:513-485-9702
Mailing Address - Street 1:20311 CHARTWELL CENTER DR UNIT 422
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5291
Mailing Address - Country:US
Mailing Address - Phone:513-485-9702
Mailing Address - Fax:
Practice Address - Street 1:20311 CHARTWELL CENTER DR UNIT 422
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5291
Practice Address - Country:US
Practice Address - Phone:513-485-9702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)