| Life Interrupted Counseling Services | |
|
4045 N Tryon St Ste A Charlotte NC 28206 | |
| (980) 404-1069 | |
| (877) 766-6203 |
| Full Name | Life Interrupted Counseling Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4045 N Tryon St Ste A, Charlotte, North Carolina |
| Authorized Official Name and Position | Keshia Donuel Keith (OWNER) |
| Authorized Official Contact | 9804041069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Interrupted Counseling Services 516 Highland Ridge Pt Clover SC 29710-5507 Ph: (980) 322-3466 | Life Interrupted Counseling Services 4045 N Tryon St Ste A Charlotte NC 28206 Ph: (980) 404-1069 |
| NPI Number | 1609433291 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609433291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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