| Community Counseling Center | |
|
4810 Wrightsville Ave Wilmington NC 28403-6917 | |
| (910) 452-7370 | |
| (910) 798-5199 |
| Full Name | Community Counseling Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4810 Wrightsville Ave, Wilmington, North Carolina |
| Authorized Official Name and Position | Sonya E. Leonard (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 9104527370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Counseling Center 4810 Wrightsville Ave Wilmington NC 28403-6917 Ph: (910) 452-7370 | Community Counseling Center 4810 Wrightsville Ave Wilmington NC 28403-6917 Ph: (910) 452-7370 |
| NPI Number | 1316177173 |
|---|---|
| Provider Enumeration Date | 07/15/2009 |
| Last Update Date | 10/29/2018 |
| Medicare PECOS PAC ID | 7911186168 |
|---|---|
| Medicare Enrollment ID | O20110120000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316177173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Wellons Hartman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265898316 PECOS PAC ID: 6406157916 Enrollment ID: I20180413000859 |
| Provider Name | Susan Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497912448 PECOS PAC ID: 4981878576 Enrollment ID: I20181030000004 |
| Provider Name | Sarah E Dietz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952724668 PECOS PAC ID: 1557734472 Enrollment ID: I20230308002893 |
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