# EQUIPOISE COUNSELING ASSOCIATES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619644044
- **Authorized official:** GWENDOLYN D HARRIS LCMHC (OWNER/THERAPIST)
- **Authorized official phone:** (309) 706-9336

## Contact information

- **Practice address:** 229 S BREVARD ST STE 200F, CHARLOTTE, NC 28202-2495
- **Practice address phone:** (704) 490-3867
- **Mailing address:** 229 S BREVARD ST STE 200F, CHARLOTTE, NC 28202-2495
- **Mailing address phone:** (704) 490-3867

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/24/2021
- **Last updated:** 08/24/2021