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Organization
KICKSTARTING INSPIRATION & NOURISHING GENTLE SOULS LLC
Active
Organization
KICKSTARTING INSPIRATION & NOURISHING GENTLE SOULS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZAQUES JAMONEZ MCCULLOUGH LCSW-A (OWNER)
(252) 375-0694
Entity
Organization
Contact information
Practice address
7319 MATTHEWS MINT HILL RD STE I, MINT HILL, NC 28227-7866
(336) 908-9595
Mailing address
7319 MATTHEWS MINT HILL RD STE I, MINT HILL, NC 28227-7866
(336) 908-9595
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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