| Moment Of Change Counseling Services, Pllc | |
|
106 Wortham Ct Henderson NC 27537-4500 | |
| (252) 320-9903 | |
| (252) 203-4050 |
| Full Name | Moment Of Change Counseling Services, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 106 Wortham Ct, Henderson, North Carolina |
| Authorized Official Name and Position | Jamie Washington (DIRECTOR) |
| Authorized Official Contact | 2523209903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moment Of Change Counseling Services, Pllc 106 Wortham Ct Henderson NC 27537-4500 Ph: (252) 320-9903 | Moment Of Change Counseling Services, Pllc 106 Wortham Ct Henderson NC 27537-4500 Ph: (252) 320-9903 |
| NPI Number | 1972123487 |
|---|---|
| Provider Enumeration Date | 04/24/2020 |
| Last Update Date | 01/09/2023 |
| Certification Date | 01/09/2023 |
| Medicare PECOS PAC ID | 0547652182 |
|---|---|
| Medicare Enrollment ID | O20220112000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972123487 | NPI | - | NPPES |
| 6103107 | Medicaid | NC |
| Provider Name | Ayauna Algernae Sumpter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679172811 PECOS PAC ID: 2567817356 Enrollment ID: I20231013003012 |
| Provider Name | Jamie Lee Washington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366954356 PECOS PAC ID: 9739500620 Enrollment ID: I20240124001197 |
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