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Organization
LIBERATION COUNSELING SERVICES PLLC
Active
Organization
LIBERATION COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE PARKS LEACH LCMHCA (THERAPIST)
(704) 418-1632
Entity
Organization
Contact information
Practice address
625 E 2ND AVE STE 9, GASTONIA, NC 28054-7102
(111) 111-1111
Mailing address
625 E 2ND AVE STE 9, GASTONIA, NC 28054-7102
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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