# AFFINITY CLINICAL SERVICES, PLLC

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

## Provider details

- **NPI number:** 1790219871
- **Authorized official:** SAMUEL NDUPU LCMHCS, CCS, LCAS (CLINICAL DIRECTOR, OWNER)
- **Authorized official phone:** (980) 224-8060

## Contact information

- **Practice address:** 5500 EXECUTIVE CENTER DRIVE, SUITE 118, CHARLOTTE, NC 28212
- **Practice address phone:** (980) 224-8060
- **Practice address fax:** (704) 379-1914
- **Mailing address:** 5500 EXECUTIVE CENTER DRIVE, SUITE 118, CHARLOTTE, NC 28212
- **Mailing address phone:** (980) 224-8060
- **Mailing address fax:** (704) 379-1914

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | 4936 | NC | — |
| 251X00000X | Supports Brokerage Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/17/2017
- **Last updated:** 06/19/2023