Provider Demographics
NPI:1992518054
Name:COUNSELING AND DIVERSION CENTER PLLC
Entity type:Organization
Organization Name:COUNSELING AND DIVERSION CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASHAWNTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCAS
Authorized Official - Phone:910-217-6445
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:MAXTON
Mailing Address - State:NC
Mailing Address - Zip Code:28364-0333
Mailing Address - Country:US
Mailing Address - Phone:910-217-6445
Mailing Address - Fax:
Practice Address - Street 1:1112 ATKINSON ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4723
Practice Address - Country:US
Practice Address - Phone:910-506-2073
Practice Address - Fax:910-506-2072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health