| Clinical Counseling And Consulting Services, Pllc | |
|
2940 Breezewood Ave Fayetteville NC 28303-5520 | |
| (910) 827-6594 | |
| (910) 827-6592 |
| Full Name | Clinical Counseling And Consulting Services, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2940 Breezewood Ave, Fayetteville, North Carolina |
| Authorized Official Name and Position | Elizabeth Caldwell (CEO/OWNER) |
| Authorized Official Contact | 9104899036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Counseling And Consulting Services, Pllc 2539 Mcarthur Landing Cir Apt 102 Fayetteville NC 28311-9019 Ph: (910) 489-9036 | Clinical Counseling And Consulting Services, Pllc 2940 Breezewood Ave Fayetteville NC 28303-5520 Ph: (910) 827-6594 |
| NPI Number | 1942744792 |
|---|---|
| Provider Enumeration Date | 12/13/2016 |
| Last Update Date | 07/11/2021 |
| Certification Date | 07/11/2021 |
| Medicare PECOS PAC ID | 6305271446 |
|---|---|
| Medicare Enrollment ID | O20200116003116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942744792 | NPI | - | NPPES |
| 1942744792 | Medicaid | NC |
| Provider Name | Elizabeth Victoria Caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801202429 PECOS PAC ID: 6709210537 Enrollment ID: I20200129003117 |
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